The aim of the study is to evaluate the effects of Herbal gargle on chemoradiotherapy-induced stomatitis in head \& neck cancer patients.
Head and neck cancer accounts for about 5% of all cancers worldwide with the age-standardized incidence rate (ASIR) of HNC increased by 5.4% per year among males and 3.1% among females in Taiwan. Concurrent chemoradiotherapy (CCRT) is the most common management to treat head and neck cancer. However, CCRT may cause much side effects such as oral mucositis, radiation dermatitis, xerostomia, or infection, which influence food intake, disturb nutritional status and interrupt the course of treatment. Traditional Chinese Medicine (TCM) has been applied to treat cancer side effects for many years. Herbal gargle is composed of TCM herbals used for oral mucositis induced by chemoradiotherapy among head and neck cancer. The aim of the trial is to evaluate the effectiveness of Herbal gargle. The participants divide into two groups, treatment group and control group. The treatment group receive Herbal gargle 150ml and are instructed to hold the gargle in the mouth for 30s and then expectorate it twice a day, 5 days a week for 8 weeks. The control group receive normal saline 150ml for oral mucositis. The subjective questionnaires of EORTC QLQ-C30, EORTC QLQ-H\&N35 are assessed twice a week, CTCAE for grading of oral mucositis is assessed once a week, VAS is assessed everyday for 8 weeks. Besides, change of opioid dosage, body weight are also recorded. The CRP is assessed before and every week for 8 weeks and the albumin and bacteria culture are assessed before and post-treatment of 4th week and 8th week. The baseline difference of treatment and control group will be analyzed by using independent t-test and the difference of evaluation scores and blood tests between pre-treatment and post-treatment will be analyzed using multivariate logistic regression analysis. A value of P \< 0.05 will be regarded as statistically significant for the above statistical analyses.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
80
The treatment group receive Herbal gargle 150ml and are instructed to hold the gargle in the mouth for 30s and then expectorate it twice a day, 5 days a week for 8 weeks.
The control group receive Normal saline 150ml and are instructed to hold the normal saline in the mouth for 30s and then expectorate it twice a day, 5 days a week for 8 weeks.
Keelung Chang Gung Memorial Hospital
Keelung, Keelung, Taiwan, Taiwan
Change of CTCAE 4.0
CTCAE is used to describe the severity of oral mucositis for patients receiving cancer therapy.
Time frame: change from baseline and every week for 8 weeks.
Change of EORTC QLQ-C30
European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire score, EORTC QLQ-C30, is used to measure cancer patients' physical, psychological and social functions.
Time frame: change from baseline at 4 weeks and 8 weeks post treatment.
Change of EORTC QLQ-H&N35
European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-head \& neck, EORTC QLQ-H\&N35, is used for assessing the health-related quality of life for head-and-neck cancer patients.
Time frame: change from baseline at 4 weeks and 8 weeks post treatment.
Change of VAS of pain of oral mucositis
Visual Analogue Scale, VAS, is used to to measure the intensity of pain of oral mucositis.
Time frame: change from baseline and everyday for 8 weeks.
Change of body weight
The oral mucositis caused by chemoradiotherapy will influence food intake. Monitor body weight provides objective evaluation of nutrition status.
Time frame: change from baseline and every week for 8 weeks.
Change of opioid use
Opioid analgesics is often prescribed for alleviating pain from oral mucositis. Monitor opioid use provides other evaluation for severity of pain and wound healing.
Time frame: change from baseline and every week for 8 weeks.
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Change of albumin
Albumin has been used as maker of nutrition status.
Time frame: change from baseline at 4 weeks and 8 weeks post treatment.
Change of CRP
C-reactive protein is used to monitor severity of oral mucositis.
Time frame: change from baseline and every week for 8 weeks.
Change of common aerobic culture
Aerobic culture is used to monitor the change of bacteria flora before and after Herbal gargle treatment.
Time frame: change from baseline and every week for 8 weeks.