Document Type : Original Article(s)
Authors
Department of Radiation Oncology, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: Colorectal cancer ranks as the third most prevalent cancer type globally. In addition to surgery, chemotherapy, and radiation therapy, being the foremost efficacious and all-encompassing treatment modalities for cancer, pelvic chemoradiotherapy is known to precipitate adverse effects, notably intestinal inflammation. This study delves into assessing the impact of curcumin on the prophylaxis and amelioration of chemoradiotherapy-induced enterocolitis in colorectal cancer patients.
Method: This randomized study encompassed 44 colorectal cancer patients undergoing standard pelvic chemoradiotherapy, allocated to either curcumin treatment (22 patients) or placebo (22 patients) groups. Patients were administered oral curcumin capsules at a daily dosage of 500 mg commencing one week before baseline and extending throughout the standard treatment regimen, adhering to the same schedule. Subsequently, patients were subjected to biweekly evaluations encompassing demographics, clinical characteristics, and manifestations of enterocolitis, with statistical analysis employing Mann-Whitney and chi-square tests. A significance threshold of P < 0.05 was employed in the study for statistical significance.
Results: The incidence of complications exhibited no statistically significant disparity between the two cohorts across diverse disease stages. Furthermore, there were no discernible discrepancies in the manifestation of varying grades of intestinal complications between the curcumin-treated and placebo groups. Predominantly, both groups experienced the most pronounced side-effects during the initial two weeks of treatment. Additionally, there was no statistically significant distinction in the prevalence of adverse drug reactions between the two groups, with figures standing at 31% versus 40% (P = 0.17).
Conclusion: Even though 500 mg/day of curcumin over a six-week duration did not engender a statistically significant reduction in the adverse effects of chemoradiotherapy, it was well-tolerated and deemed safe in this patient cohort.
Highlights
Nadia Najafizade (Google Scholar)
Simin Hemati (Google Scholar)
Keywords
Main Subjects
How to cite this article:
Najafizade N, Ebrahimi A, Hemati S. A randomized, double-blinded, placebocontrolled study on the protective effects of curcumin against chemoradiotherapyinduced enteritis. Middle East J Cancer. 2024;15(3):199-206. doi:10.30476/mejc.2023.96676.1831.
- Ballas LK, Elkin EB, Schrag D, Minsky BD, Bach PB. Radiation therapy facilities in the United States. Int J Radiat Oncol Biol Phys. 2006;66(4):1204-11. doi: 10.1016/j.ijrobp.2006.06.035.
- Wang J, Boerma M, Fu Q, Hauer-Jensen M. Significance of endothelial dysfunction in the pathogenesis of early and delayed radiation enteropathy. World J Gastroenterol. 2007;13(22):3047-55. doi: 10.3748/wjg.v13.i22.3047.
- Zhang QY, Wang FX, Jia KK, Kong LD. Natural product interventions for chemotherapy and radiotherapy-induced side effects. Front Pharmacol. 2018;9:1253. doi: 10.3389/fphar.2018.01253.
- Wong KE, Ngai SC, Chan KG, Lee LH, Goh BH, Chuah LH. Curcumin nanoformulations for colorectal cancer: a review. Front Pharmacol. 2019;10(152). doi: 10.3389/fphar.2019.00152.
- Shapiro CL. Highlights of recent findings on quality-of-life management for patients with cancer and their survivors. JAMA Oncol. 2016;2(11):1401-2. doi: 10.1001/jamaoncol.2016.3620.
- Turcotte LM, Liu Q, Yasui Y, Arnold MA, Hammond S, Howell RM, et al. Temporal trends in treatment and subsequent neoplasm risk among 5-year survivors of childhood cancer, 1970-2015. JAMA. 2017;317(8):814-24. doi: 10.1001/jama.2017.0693.
- Pía de la Maza M, Gotteland M, Ramírez C, Araya M, Yudin T, Bunout D, et al. Acute nutritional and intestinal changes after pelvic radiation. J Am Coll Nutr. 2001;20(6):637-42. doi: 10.1080/07315724.2001.10719161.
- Galland RB, Spencer J. The natural history of clinically established radiation enteritis. Lancet. 1985;1(8440):1257-8. doi: 10.1016/s0140-6736(85)92322-0.
- Yeoh EK, Horowitz M, Russo A, Muecke T, Robb T, Chatterton BE. Gastrointestinal function in chronic radiation enteritis--effects of loperamide-N-oxide. Gut. 1993;34(4):476-82. doi: 10.1136/gut.34.4.476.
- Shabeeb D, Musa AE, Abd Ali HS, Najafi M. Curcumin protects against radiotherapy-induced oxidative injury to the skin. Drug Des Devel Ther. 2020;14:3159-63. doi: 10.2147/DDDT.S265228.
- Sharma RA, Steward WP, Gescher AJ. Pharmacokinetics and pharmacodynamics of curcumin. Adv Exp Med Biol. 2007;595:453-70. doi: 10.1007/978-0-387-46401-5_20.
- Kunnumakkara AB, Diagaradjane P, Guha S, Deorukhkar A, Shentu S, Aggarwal BB, et al. Curcumin sensitizes human colorectal cancer xenografts in nude mice to gamma-radiation by targeting nuclear factor-kappaB-regulated gene products. Clin Cancer Res. 2008;14(7):2128-36. doi: 10.1158/1078-0432.CCR-07-4722.
- Xiao Y, Xia J, Wu S, Lv Z, Huang S, Huang H, et al. Curcumin inhibits acute vascular inflammation through the activation of heme oxygenase-1. Oxid Med Cell Longev. 2018;2018:3295807. doi: 10.1155/2018/3295807.
- Sreejayan N, Rao MNA, Priyadarsini KI, Devasagayam TPA. Inhibition of radiation-induced lipid peroxidation by curcumin. Int J of Pharm. 1997;151(1):1127-30. doi:10.1016/S0378-5173(97)04900-4.
- Goel A, Kunnumakkara AB, Aggarwal BB. Curcumin as "Curecumin": from kitchen to clinic. Biochem Pharmacol. 2008;75(4):787-809. doi: 10.1016/j.bcp.2007.08.016.
- Ryan JL, Heckler CE, Ling M, Katz A, Williams JP, Pentland AP, et al. Curcumin for radiation dermatitis: a randomized, double-blind, placebo-controlled clinical trial of thirty breast cancer patients. Radiat Res. 2013;180(1):34-43. doi: 10.1667/RR3255.1.
- Yeoh EK, Horowitz M. Radiation enteritis. Surg Gynecol Obstet. 1987;165(4):373-9.
- Bairati I, Meyer F, Gélinas M, Fortin A, Nabid A, Brochet F, et al. Randomized trial of antioxidant vitamins to prevent acute adverse effects of radiation therapy in head and neck cancer patients. J Clin Oncol. 2005;23(24):5805-13. doi:10.1200/JCO.2005.05.514.
- Verma V. Relationship and interactions of curcumin with radiation therapy. World J Clin Oncol. 2016;7(3):275-83. doi: 10.5306/wjco.v7.i3.275.
- Patil K, Guledgud MV, Kulkarni PK, Keshari D, Tayal S. Use of Curcumin mouthrinse in radio-chemotherapy induced oral mucositis patients: a pilot study. J Clin Diagn Res. 2015;9(8):ZC59-62. doi: 10.7860/JCDR/2015/13034.6345.
- Ramezani V, Ghadirian S, Shabani M, Boroumand MA, Daneshvar R, Saghafi F. Efficacy of curcumin for amelioration of radiotherapy-induced oral mucositis: a preliminary randomized controlled clinical trial. BMC Cancer. 2023;23(1):354. doi:10.1186/s12885-023-10730-8.
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