Herbal Medicine in Head and Neck Cancer: A Review of Randomized Controlled Trial
,
Abstract
Head and neck cancer (HNC) is a significant global health issue, ranking as the seventh most common cancer worldwide in 2020. Standard treatments like surgery, radiotherapy, and chemotherapy often lead to adverse effects such as oral mucositis (OM) and gastrointestinal complications, which negatively impact patients' quality of life (QoL). The use of herbal medicine has emerged as a complementary approach to mitigate these side effects. This review aims to explore and assess the overview and outcomes of herbal medicine use in HNC patients through a review of randomized controlled trial (RCTs) studies. Articles were searched until to October 19, 2024, using two databases: PubMed and The Cochrane Library with the keywords and combinations of ‘AND’ and ‘OR’ to search for relevant studies. Out of 1,312 articles identified, 11 studies met the inclusion criteria. These studies were conducted in diverse regions, including Iran, Japan, Taiwan, India, China, Germany, and Brazil, with sample sizes ranging from 20 to 74 participants. Herbal medicine showed potential benefits in managing OM, improving gastrointestinal motility, and alleviating xerostomia. Herbal medicines demonstrate promising efficacy and safety profiles in managing HNC-related complications, such as OM, gastrointestinal issues, and QoL. These findings suggest the potential integration of herbal medicine into HNC management as an innovative and supportive care strategy.
Ng JY, Dogadova E. The Presence of Complementary and Alternative Medicine Recommendations in Head and Neck Cancer Guidelines: Systematic Review and Quality Assessment 1912. https://doi.org/10.1007/s11912-021-01024-y/Published.
Samara P, Athanasopoulos M, Mastronikolis S, Kyrodimos E, Athanasopoulos I, et al. The role of oncogenic viruses in head and neck cancers: epidemiology, pathogenesis, and advancements in detection methods. Microorganisms 2024;12. https://doi.org/10.3390/microorganisms12071482.
Tsai YL, Kang YT, Chan HC, Chattopadhyay A, Chiang CJ, et al. Population-based prognostic models for head and neck cancers using national cancer registry data from taiwan. J Epidemiol Glob Health 2024;14:433-443.
Zhou T, Huang W, Wang X, Zhang J, Zhou E, et al. Global burden of head and neck cancers from 1990 to 2019. IScience 2024;27. https://doi.org/10.1016/j.isci.2024.109282.
Shah S, Rath H, Sharma G, Senapati S, Mishra E. Effectiveness of curcumin mouthwash on radiation-induced oral mucositis among head and neck cancer patients: A triple-blind, pilot randomised controlled trial. Indian J Dental Res 2020;31:718-727.
Moriyama S, Hinode D, Yoshioka M, Sogawa Y, Nishino T, et al. Impact of the use of Kampo medicine in patients with esophageal cancer during chemotherapy: a clinical trial for oral hygiene and oral condition. J Med Invest 2018;65:184-190.
Manoharan S, Kavitha K, Senthil N, Renju GL. Evaluation of anticarcinogenic effects of Clerodendron inerme on 7, 12-dimethylbenz (a) anthracene-induced hamster buccal pouch carcinogenesis. Singapore Med J 2006;47:1038-1043.
Chen T, Yan F, Qian J, Guo M, Zhang H, et al. Randomized phase II trial of lyophilized strawberries in patients with dysplastic precancerous lesions of the esophagus. Cancer Prevention Res 2012;5:41-50.
Nishino T, Yoshida T, Goto M, Inoue S, Minato T, et al. The effects of the herbal medicine Daikenchuto (TJ-100) after esophageal cancer resection, open-label, randomized controlled trial. Esophagus 2018;15:75-82.
McCormick F, Cvetanovich GL, Kim JM, Harris JD, Gupta AK, et al. An assessment of the quality of rotator cuff randomized controlled trials: utilizing the Jadad score and CONSORT criteria. J Shoulder Elbow Surg 2013;22:1180-1185.
Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJM, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996;17:1-12.
Pergialiotis V, Vlachos D-EG, Kontzoglou K, Perrea D, Vlachos GD. Pulmonary recruitment maneuver to reduce pain after laparoscopy: a meta-analysis of randomized controlled trials. Surg Endosc 2015;29:2101-2108.
Halpern SH, Douglas MJ. Appendix: Jadad scale for reporting randomized controlled trials. Evidence-Based Obstetric Anesthesia 2005:237-238.
Kia SJ, Basirat M, Saedi HS, Arab SA. Effects of nanomicelle curcumin capsules on prevention and treatment of oral mucosits in patients under chemotherapy with or without head and neck radiotherapy: a randomized clinical trial. BMC Complement Med Ther 2021;21. https://doi.org/10.1186/s12906-021-03400-4.
Martins AFL, Pereira CH, Morais MO, de Sousa-Neto SS, Valadares MC, et al. Effects of a mucoadhesive phytomedicine (Curcuma longa L. and Bidens pilosa L.) on radiotherapy-induced oral mucositis and quality of life of patients undergoing head and neck cancer treatment: randomized clinical trial. Supportive Care in Cancer 2023;31.
Lin KS, Jen YM, Chao TY, Lin YS, Wang LH, et al. Prevention of acute radiation-associated toxicity by traditional chinese medicine Tianwang Buxin Mini-pills in patients with head and neck cancer. J Med Sci 2014;34:152-160.
Rezaeipour N, Jafari F, Rezaeizadeh H, Nasseri M, Kamalinejad M, et al. Efficacy of a persian medicine herbal compound (Alcea digitata alef and malva sylvestris l.) on prevention of radiation induced acute mucositis in patients with head and neck cancer: A pilot study. Int J Cancer Manag 2017;10. https://doi.org/10.5812/ijcm.8642.
Zejun X, Cuiping X, Hongxia G, Yan L, Liangliang C, et al. Modified Dachengqi Tang improves decreased gastrointestinal mo-tility in postoperative esophageal cancer patients. Trad Chin Med 2015;35:166.
Cheng YC, Wang YM, Lin YH, Cheng JY, Li SH, et al. Preventive effect and safety of Chinese herbal medicine for oral mucositis during radiotherapy in patients with head and neck cancer: Study protocol for a randomized trial. Contemp Clin Trials Commun 2022;27.
Ameri A, Heydarirad G, Rezaeizadeh H, Choopani R, Ghobadi A, et al. Evaluation of efficacy of an herbal compound on dry mouth in patients with head and neck cancers: a randomized clinical trial. J Evid Based Complementary Altern Med 2016;21:30-33.
Klopp R, Schmidt W, Werner M, Beuth J. Lokale und systemische Reaktionen auf den Funktionszustand der Mikrozirkulation und Verhaltensmerkmale weißer Blutzellen nach Anwendung von standardisiertem Mistelextrakt. Deutsche Zeitschrift Für Onkologie 2001;33:6-14.
Klopp R, Schmidt W, Werner E, Werner M, Niemer W, et al. Influence of complementary Viscum album (Iscador®) administration on microcirculation and immune system of ear, nose and throat carcinoma patients treated with radiation and chemotherapy. Anticancer Res 2005;25:601-610.
Shah S, Rath H, Sharma G, Senapati S, Mishra E. Effectiveness of curcumin mouthwash on radiation-induced oral mucositis among head and neck cancer patients: A triple-blind, pilot randomised controlled trial. Indian J Dental Res 2020;31:718–27.
Fournier-Larente J, Azelmat J, Yoshioka M, Hinode D, Grenier D. The Daiokanzoto (TJ-84) Kampo formulation reduces virulence factor gene expression in Porphyromonas gingivalis and possesses anti-inflammatory and anti-protease activities. PLoS One 2016;11:e0148860.
Taira K, Fujiwara K, Fukuhara T, Koyama S, Takeuchi H. The effect of hangeshashinto on oral mucositis caused by induction chemotherapy in patients with head and neck cancer. Yonago Acta Med 2020;63:183-187.
Marx RE, Stern D. Oral and maxillofacial pathology: a rationale for diagnosis and treatment. Quintessence 2012.
da Cruz Campos MI, Neiva Campos C, Monteiro Aarestrup F, Vieira Aarestrup BJ. Oral mucositis in cancer treatment: Natural history, prevention and treatment. Mol Clin Oncol 2014;2:337-40.
Al-Dasooqi N, Keefe DM, Keefe DM, Sonis ST. Mucositis. Pathobiology of Cancer Regimen-Related Toxicities 2013:121-146.
Ravindran PN, Babu KN, Sivaraman K. Turmeric: the genus Curcuma. CRC press; 2007.
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:ZC59.
Elad S, Meidan I, Sellam G, Simaan S, Zeevi I, et al. Topical curcumin for the prevention of oral. Health Med 2013;19:21-24.
Zhang Q-Y, Wang F-X, Jia K-K, Kong L-D. Natural product interventions for chemotherapy and radiotherapy-induced side effects. Front Pharmacol 2018;9:1253.
Wei L, Wen X-S, Xian CJ. Chemotherapy-induced intestinal microbiota dysbiosis impairs mucosal homeostasis by modulating toll-like receptor signaling pathways. Int J Mol Sci 2021;22:9474.
Lee C-T, Kuo H-C, Chen Y-H, Tsai M-Y. Current advances in the biological activity of polysaccharides in Dendrobium with intriguing therapeutic potential. Curr Med Chem 2018;25:1663-1681.
Wu X, Dai H, Huang L, Gao X, Tsim KWK, et al. A fructan, from Radix ophiopogonis, stimulates the proliferation of cultured lymphocytes: structural and functional analyses. J Nat Prod 2006;69:1257-1260.
Chen M-H, Chen X-J, Wang M, Lin L-G, Wang Y-T. Ophiopogon japonicus—A phytochemical, ethnomedicinal and pharmacological review. J Ethnopharmacol 2016;181:193-213.
Teseo S, Houot B, Yang K, Monnier V, Liu G, et al. sinense and P. notoginseng extracts improve healthspan of aging flies and provide protection in a huntington disease model. Aging Dis 2021;12:425.
Fukamachi H, Matsumoto C, Omiya Y, Arimoto T, Morisaki H, et al. Effects of Hangeshashinto on growth of oral microorganisms. Evid Based Complement Alternat Med 2015;2015:512947.
Liao J, Zhao L, Yoshioka M, Hinode D, Grenier D. Effects of Japanese traditional herbal medicines (Kampo) on growth and virulence properties of Porphyromonas gingivalis and viability of oral epithelial cells. Pharm Biol 2013;51:1538-1544.
Song J-H, Yang T-C, Chang K-W, Han S-K, Yi H-K, et al. In vitro anti-cariogenic activity of dichloromethane fraction from Rheum undulatum L. root. Arch Pharm Res 2006;29:490-496.
Kim J-E, Kim H-J, Pandit S, Chang K-W, Jeon J-G. Inhibitory effect of a bioactivity-guided fraction from Rheum undulatum on the acid production of Streptococcus mutans biofilms at sub-MIC levels. Fitoterapia 2011;82:352-356.
Braga F do PF, Lemos Junior CA, Alves FA, Migliari DA. Acupuncture for the prevention of radiation-induced xerostomia in patients with head and neck cancer. Braz Oral Res 2011;25:180-185.
Hameed HA, Waris Nawab S. Avicenna [The Canon of Medicine] 1998.
Ameri A, Heydarirad G, Mahdavi Jafari J, Ghobadi A, Rezaeizadeh H, et al. Medicinal plants contain mucilage used in traditional Persian medicine (TPM). Pharm Biol 2015;53:615-623.
Kardošová A, Machová E. Antioxidant activity of medicinal plant polysaccharides. Fitoterapia 2006;77:367-373.
Razavi SM, Zarrini G, Molavi G, Ghasemi G. Bioactivity of Malva sylvestris L., a medicinal plant from Iran. Iran J Basic Med Sci 2011;14:574.
Prudente AS, Loddi AM V, Duarte MR, Santos ARS, Pochapski MT, et al. Pre-clinical anti-inflammatory aspects of a cuisine and medicinal millennial herb: Malva sylvestris L. Food Chem Toxicol 2013;58:324-331.
Jafari-Sales A, Jafari B, Sayyahi J, Zohoori-Bonab T. Evaluation of antibacterial activity of ethanolic extract of malva neglecta and althaea officinalis l. On antibiotic-resistant strains of staphylococcus aureus. J Biol Today World 2015;4:58-62.
Eubank PLC, Abreu LG, Violante IP, Volpato LER. Medicinal plants used for the treatment of mucositis induced by oncotherapy: a systematic review. Supportive Care in Cancer 2021;29:6981-6993.
Bastos CCC, de Ávila PHM, dos Santos Filho EX, de Ávila RI, Batista AC, et al. Use of Bidens pilosa L.(Asteraceae) and Curcuma longa L.(Zingiberaceae) to treat intestinal mucositis in mice: Toxico-pharmacological evaluations. Toxicol Rep 2016;3:279-287.
Horiuchi M, Wachi H, Seyama Y. Effects of Bidens pilosa L. var. radiata S cherff on experimental gastric lesion. J Nat Med 2010;64:430-435.
Raymond D. Complications of esophagectomy. Surgical Clinics 2012;92:1299-1313.
Yoshikawa K, Shimada M, Nishioka M, Kurita N, Iwata T, et al. The effects of the Kampo medicine (Japanese herbal medicine)“Daikenchuto” on the surgical inflammatory response following laparoscopic colorectal resection. Surg Today 2012;42:646-651.
Klopp R, Schmidt W, Niemer W, Werner M, Beuth J. Changes in immunological characteristics of white blood cells after administration of standardized mistletoe extract. In Vivo 2001;15:447-457.
Xu GZ, Cai WM, Yan JH, Wu XL, Zhang HX, et al. Chinese herb “destagnation” series I: combination of radiation with destagnation in the treatment of nasopharyngeal carcinoma (NPC): a prospective randomized trial on 188 cases. Int J Radiat Oncol Biol Phys 1989;16:297-300.
| Issue | Vol. 11, No. 2, 2026 -In Press- | |
| Section | Review Article(s) | |
| Keywords | ||
| Head and neck cancer Herbal medicine HNC | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
