TY - JOUR
T1 - Beneficial Effects of Adjuvant Melatonin in Minimizing Oral Mucositis Complications in Head and Neck Cancer Patients Receiving Concurrent Chemoradiation
AU - Onseng, Kittipong
AU - Johns, Nutjaree Pratheepawanit
AU - Khuayjarernpanishk, Thanut
AU - Subongkot, Suphat
AU - Priprem, Aroonsri
AU - Hurst, Cameron
AU - Johns, Jeffrey
N1 - Funding Information:
This study was sponsored by the Khon Kaen University grant. The authors have full control of all primary data and agree to allow the Journal to review the data if requested. The authors declare no conflicts of interest.
PY - 2017/12
Y1 - 2017/12
N2 - Objectives: Oral mucositis is a major cause of pain and delayed cancer treatment leading to poor survival in head and neck cancer patients receiving concurrent chemoradiation. The study evaluated the effect of adjuvant melatonin on minimizing oral mucositis complications to reduce these treatment delays and interruptions. Design: A randomized, double-blind, double dummy, placebo-controlled clinical trial. Setting: Ubon Ratchathani Cancer Hospital, Thailand. Participants: Thirty-nine head and neck cancer patients receiving concurrent chemoradiation (5 days/week of radiation plus chemotherapy three or six cycles). Methods: Patients were randomized to receive 20 mg melatonin gargle (or matched placebo) before each irradiation, and 20 mg melatonin capsules (or matched placebo) taken nightly during 7 weeks of concurrent chemoradiation. Endpoints were oral mucositis events (incidence and time to grade 3 mucositis or grade 2 xerostomia), pain medication consumption and quality of life (QOL). Results: Melatonin group reported lower incidence of grade 3 oral mucositis (42% vs. 55%) and grade 2 xerostomia (20% vs. 21%); no statistical significance was detected. Melatonin regimen delayed onset of grade 3 mucositis (median 34 days vs. 50 days; p = 0.0318), allowing median time of 16 more patient visits before its onset and fewer interrupted treatments due to oral mucositis were reported (n = 1 vs. n = 5). There was no difference of grade 2 xerostomia (median 32 days vs. 50 days; p = 0.624). Morphine consumption was also reduced (median 57 mg vs. 0 mg; p = 0.0342), while QOL was comparable during the study period. Conclusion: Adjuvant melatonin delayed the onset of oral mucositis, which enables uninterrupted cancer treatment and reduced the amount of morphine used for pain treatment.
AB - Objectives: Oral mucositis is a major cause of pain and delayed cancer treatment leading to poor survival in head and neck cancer patients receiving concurrent chemoradiation. The study evaluated the effect of adjuvant melatonin on minimizing oral mucositis complications to reduce these treatment delays and interruptions. Design: A randomized, double-blind, double dummy, placebo-controlled clinical trial. Setting: Ubon Ratchathani Cancer Hospital, Thailand. Participants: Thirty-nine head and neck cancer patients receiving concurrent chemoradiation (5 days/week of radiation plus chemotherapy three or six cycles). Methods: Patients were randomized to receive 20 mg melatonin gargle (or matched placebo) before each irradiation, and 20 mg melatonin capsules (or matched placebo) taken nightly during 7 weeks of concurrent chemoradiation. Endpoints were oral mucositis events (incidence and time to grade 3 mucositis or grade 2 xerostomia), pain medication consumption and quality of life (QOL). Results: Melatonin group reported lower incidence of grade 3 oral mucositis (42% vs. 55%) and grade 2 xerostomia (20% vs. 21%); no statistical significance was detected. Melatonin regimen delayed onset of grade 3 mucositis (median 34 days vs. 50 days; p = 0.0318), allowing median time of 16 more patient visits before its onset and fewer interrupted treatments due to oral mucositis were reported (n = 1 vs. n = 5). There was no difference of grade 2 xerostomia (median 32 days vs. 50 days; p = 0.624). Morphine consumption was also reduced (median 57 mg vs. 0 mg; p = 0.0342), while QOL was comparable during the study period. Conclusion: Adjuvant melatonin delayed the onset of oral mucositis, which enables uninterrupted cancer treatment and reduced the amount of morphine used for pain treatment.
KW - cancer
KW - chemoradiation
KW - head and neck
KW - melatonin
KW - mucositis
UR - http://www.scopus.com/inward/record.url?scp=85038931435&partnerID=8YFLogxK
U2 - 10.1089/acm.2017.0081
DO - 10.1089/acm.2017.0081
M3 - Article
C2 - 28657801
VL - 23
SP - 957
EP - 963
JO - Journal of Alternative and Complementary Medicine
JF - Journal of Alternative and Complementary Medicine
SN - 1075-5535
IS - 12
ER -