Use of Aloe Vera to Prevent Oral Mucositis: A Systematic Review

Öz

Oral Mukoziti Önlemede Aloe Vera Kullanımı: Sistematik Derleme

Öz

ÖZET Kanser tedavisinde kullanılan kemoterapi(KT) ve radyoterapi(RT) bireyde birçok komplikasyona neden olmaktadır. Bu komplikasyonlardan biri de oral mukozitlerdir. Oral mukozitin önlenmesi ve tedavisi ile ilgili en etkili yöntemin ne olduğu hakkında fikir birliği olmaması nedeniyle sorun güncelliğini korumakta ve yeni yöntemlerin etkinliği araştırılmaktadır. Kanser tedavisi ile ilişkili diğer semptomlarda olduğu gibi oral mukozit yönetimine ilişkin kanıt oluşturmak amacıyla da çok sayıda tamamlayıcı tedavinin etkinliği araştırılmıştır. “Aloe vera” son yıllarda popülaritesi artan, bir üründür. Aloe veranın daha çok baş boyun kanserlerinde ve radyoterapi alan bireylerde oral mukozit üzerindeki etkisi değerlendirilmiş olumlu sonuçlar alınmış ve yan etki yaşanmadığı bildirilmiştir. Çalışmanın amacı kanser hastalarında hastalık ve tedaviye bağlı gelişen oral mukozitte aoe vera kullanımının etkinliğine yönelik yapılmış çalışma sonuçlarını incelemektir. Bu sistematik derlemenin evrenini Şubat-Nisan 2020 tarihlerinde “kanser hastaları-cancer patients”, “oral mukozit-oral mucositis”,“ağız bakımı-oral care” ve “aloe vera” anahtar kelimeleriyle “Medline”, “Ebscohost”, “Pubmed”, “Science Direct” ve “Google Scholar” veri tabanları taranarak ulaşılan 6 makale oluşturmuştur. Araştırmanın kontrol edilmesinde “Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)” kontrol listesi kullanılmıştır. Aloe veranın iyileşme süresi, ağrı skoru, mukozit görülme sıklığı, mukozit şiddetini önleme ya da azaltma konusunda yararları olduğu, yaşam kalitesini iyileştirdiği ve yan etkileri olmaması nedeniyle mukozit tedavisinde kullanımı önerilmektedir. ABSTRACT Chemotherapy (CT) and radiotherapy (RT) used in cancer treatment cause many complications in the individual. One of these complications is oral mucositis. Since there is no consensus on the most effective method for the prevention and treatment of oral mucositis, the problem remains current and the effectiveness of new methods is being investigated. As with other symptoms associated with cancer therapy, the efficacy of numerous complementary therapies has been investigated to establish evidence for the management of oral mucositis. “Aloe vera” is a product whose popularity has increased in recent years. The effect of aloe vera on oral mucositis was evaluated mostly in head and neck cancers and in individuals receiving radiotherapy, and positive results were obtained and no side effects were reported. To examine the results of studies on the effectiveness of the use of aoe vera in oral mucositis due to disease and treatment in cancer patients. The universe of this systematic review was collected between February-April 2020 with the keywords "cancer patients-cancer patients", "oral mucositis-oral mucositis", "oral care-oral care" and "aloe vera" with the keywords "Medline", "Ebscohost", "Pubmed". ”, “Science Direct” and “Google Scholar” databases were searched and 6 articles were reached. The "Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)" checklist was used to control the research. Aloe vera is recommended to be used in the treatment of mucositis because it has benefits in terms of recovery time, pain score, incidence of mucositis, prevention or reduction of mucositis severity, improves quality of life and does not have side effects. Key words: Aloe vera; mucositis; systematic review.

Anahtar Kelimeler

• Aloe vera;
• mukozit;
• sistematik derleme.

Kaynakça

1. KAYNAKÇA Acharya, JK., Beniwal, S., Jakhar, S., Mohta, N.(2018). Aloe Vera: A multifaceted ayurvedic herb used in palliative care of oral cancer patients. Annals Of Oncology, 29(9) doı.org/10.1093/annonc/mdy440.003.
2. Aghamohammadi, A., Hosseinimehr, SJ.(2016). Natural products for management of oral mucositis ınduced by radiotherapy and chemotherapy. Integrative Cancer Therapies, 15(1) :60-8. doi: 10.1177/1534735415596570.
3. Agaçdiken, S., Kara M.(2014). The effect of mouth care with aloe vera solution on mucositis: treatment in patients with chronic obstructive pulmonary disease (Copd). J Oral Hyg Health, 2;168. doi:10.4172/2332-0702.1000168.
4. Ahmadi, A.(2012). Potential prevention: Aloe vera mouthwash may reduce radiation-induced oral mucositis in head and neck cancer patients. Chin J Integr Med, 18:635-80. doı:org/10.1007/s11655-012-1183-y.
5. Babaee, N., Zabihi, E., Mohseni, S., Moghadamnia, A.A.(2012). Evaluation of the therapeutic effects of Aloe vera gel on minor recurrent aphthous stomatitis. Dent Res J, 9:381-85. doi: 23162576.
6. Baysal, E., Sarı, D.(2017). Evidence based complementary and alternative methods used in the prevention and treatment of oral mucositis in cancer: Literature review. Spatula, 7(1):1-13. doı: 10.5455/spatula.20170813094518.
7. Berk, D. (2018). Kemoterapi alan kanser hastalarında mukozit yönetimi. Mucositis Management in Cancer Patients With Chemotherapy,28(3): 10–15. Cancer incidense rates (ET:30.07.2020). Erişim adresi: https://cancerstatisticscenter.cancer.org.
8. Carulli, G., Rocco, M., Panichi, A.(2013). Treatment of oral mucositis in hematologic patients undergoing autologous or allogeneic transplantation of peripheral blood stem cells: a prospective, randomized study with a mouthwash containing camelia sinensis leaf extract. Hematol Rep,5(1):21-25. doı:10.4081/hr.2013.e6.

9. Chiappelli, F.(2005). The molecular ımmunology of mucositis: ımplications for evidence-based research in alternative and complementary palliative treatments. CAM,2(4):489–494 doı:10.1093/ecam/neh129.
10. Çıtlak, K., Kapucu, S.(2015). Kemoterapi alan hastalarda görülen oral mukozitin önlemesi ve tedavisinde güncel yaklaşımlar: Kanıta Dayalı Uygulamalar. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi,2(1) :70–77.
11. Elting, LS., Cooksley, CD., Chambers, MS., Garden, AS.(2007). Risk, outcomes, and costs of radiation-induced oral mucositis among patients with head-and-neckmalignancies. Int J Radiat Oncol Biol Phys, 68:1110–1120. doı: 10.1016/j.ijrobp.2007.01.053.
12. Epstein, JB., Thariat, J., Bensadoun, RJ., Barasch, A., Murphy, BA.(2012). Oral complications of cancer and cancer therapy: from cancer treatment to survivorship. Cancer J Clin, 62: 400–422. doı: 10.3322/caac.21157.
13. Epstein, JB., Schubert, MM.(2003). Oropharyngeal mucositis in cancer therapy. Oncology, 17(12): 1767-177. doi: 14723014. Güngörmüş, Z., Erdem, ÖB.(2014). Kanser hastalarında yaşam kalitesi ve oral mukozit. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 5(1) :24-30.
14. İzgü, N.(2017). Kanser tedavisine bağlı gelişen oral mukozit yönetiminde kanıt temelli uygulamalar. Hemşirelikte Eğitim ve Araştırma Dergisi,14(4):304–310.
15. Lakhani, R., Mahadalkar, P.(2017). Effectiveness of topical application of aloe vera gel on radiationinduced mucositis in patients receiving radiotherapy for head andneck malignancies. IJNR,(3):92-98. doi:10.4172/1948-5956-C1-105.
16. Lima, ICG., Maior, SM., Gueiros, L.(2021). Clinical applicability of natural products for prevention and treatment of oral mucositis: a systematic review and meta-analysis. Clin Oral Invest, 1-10. doi.org/10.1007/s00784-020-03743-1.
17. Madhuri, A.S.(2004). Aloe Vera – A Miracle Herb. Internatıonal Journal of Research In Dentıstry, 4(2):22-31.
18. Mansour, G., Ouda, S., Shaker, A., Abdallah, HM.(2014). Clinical efficacy of new aloe vera-and myrrh-based oral mucoadhesive gels in the management of minor recurrent aphthous stomatitis: a randomized, double-blind, vehicle-controlled study. J Oral Pathol Med, 43:405-09. doı: 10.1111/jop.12130.
19. Mansouri, P., Haghighi, M., Beheshtipour, N., Ramzi, M.(2016).The effect of aloe vera solution on chemotherapy-ınduced stomatitis in clients with lymphoma and leukemia: a randomized controlled clinical trial. Int J Community Based Nurs Midwifery,4(2):119-126.doi: 27218109.
20. Mansourian, A., Momen-Heravi, F., Saheb-Jamee, M., Esfehani, M., Khalilzadeh, O., Momen-Beitollahi, J.(2011). Comparison ofaloe vera mouthwash with triamcinolone acetonide 0.1% on oral lichen planus: a randomized double-blinded clinical. J Med Sci, 342:447–451. doi: 10.1097/MAJ.0b013e3182171164.
21. Martinez, J.M., Pereira, P., Chacim, S., Mesquita, E., Sousa, I., Martins, A., Azevedo, T., Mariz J.(2014). Mucositis care in acute leukemia and non-Hodgkin lymphoma patients undergoing high-dose chemotherapy. Support Care Cancer,22:2563–2569. doi:10.1007/s00520-014-2199-y. Moher, D., Liberati, A., Tetzlaff, J., Altman, DG.(2009). The PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement, 6(7): e1000097. doi:10.1371/journal.pmed1000097.
22. Morales, BI., Rojas, G., Ortega, PA., Espinoza, I., Soto, L., Plaza, A.(2012). Evaluation of the efficacy of two mouthrinses formulated for the relief of xerostomia of diverse origin in adult subjects. Gerodontology, 29(2):1103-12.
23. Nair, GR., Naidu, GS., Jain, S., Nagi, R., Makkad, RS., Jha, A. (2016). Clinical effectiveness of aloe vera in the management of oral mucosal diseases- a systematic review. J Clin Diagn Res., 10(8):1-7. doi: 10.7860/JCDR/2016/18142.8222.
24. Ovayolu, Ö., Ovayolu, N.(2013). Onkolojide semptom yönetiminde kullanılan kanıt temelli tamamlayıcı yöntemler ve etkileri. ERÜ Sağlık Bilimleri Fakültesi Dergisi, 1(1): 83-98.
25. Owlia, F., Kazemeini, SK., Gholami, N.(2012). Prevention and management of mucositis in patients with cancer: a review article. Iran J Cancer Prev,5(4):216-220. doi:25352973.
26. Pandey, A., Shweta, S.(2016). Aloe vera: A systematic review of its ındustrial and ethno-medicinal efficacy.Int. J. Pharm. Res. Allied Sci.,5(1):21-33.
27. Pathak, D., Sharma, R.(2017). Revıew on aloe vera- medıcınal plant. IJARIIE,3(1): 2395-4396. http://ijariie.com/adminuploadpdf/revıew_on_%e2%80%9caloe_vera__medıcınal_plant%e2%80%9d_ijariie3726.pdf.
28. Puataweepong, P., Dhanachai, M.(2009) The efficacy of oral Aloe-vera juice for RIM in HNM-patients: a double-blind-study. Asian.Biomed , 3:375- 382. doi:10.5372/abm.v3ı4.233.
29. Park, Y., Seung, KL.(2006). New Perspectives on Aloe. Springer Science Business Media.
30. Sahebnasagh, A., Akbari, J., Alipour, A., Lashkardoost, H., Shahram, A., Salehifar, S.(2017). Successful treatment of acute radiation proctitis with aloe vera: a preliminary randomized controlled clinical trial. The Journal of Alternative and Complementary Medicine,23(11):858-865. doi.org/10.1089/acm.2017.0047.
31. Saadeh,C.E.(2005). Chemotherapy‐ and radiotherapy‐ınduced oral mucositis: review of preventive strategies and treatment. Pharmacotherapy, 25(4):540–554. doi: 10.1592/phco.25.4.540.61035.
32. Sadasivan, R.(2010).Chemotherapy-induced oral mucositis. Oncological Review, 6:13–6 doi: 10.17925/OHR.2010.06.0.13.
33. Sahebjamee, M., Mansourian, A., Mohammad, MH., Zadeh, MT., Bekhradi, R., Kazemian, A., Manifar, S., Ashnagar, S., Doroudgar, K.(2015). Comparative efficacy of aloe vera and benzydamine mouthwashes on radiation-induced oral mucositis: a triple-blind, randomised, controlled clinical trial. Oral Health Prev Dent, 13(4):309-15. doi: 10.3290/j.ohpd.a33091.
34. Su, CK., Mehta, V., Ravikumar, L., Shah, R., Pinto, H., Halpern, J.(2004). Phase II double- blind randomized study comparing oral Aloe vera versusplacebo to prevent radiation-related mucositis in patients with head-and-neck neoplasms. Int J Radiat Oncol Biol Phys, 60:171-77. doi: 10.1016/j.ijrobp.2004.02.012.
35. Sonis, T.(2009). Mucositis: The impact, biology and therapeutic opportunities of oral mucositis Oral Oncology,45(12): 1015-1020.
36. Yıllar O. (2017).Aloe Vera Jel ve Aloe. 5. Baskı.İstanbul:Ofset Matbaacılık.
37. Yayla, EM. (2016). Mukozite yönelik kanıta dayalı uygulamalar. Hemşirelikte Eğitim ve Araştırma Dergisi, 14(3): 223-227. Zhang, Q.Y., Wang, F.X., Jia, K. K., Kong, L. D.(2018). Natural product interventions for chemotherapy and radiotherapy-induced side effects. Frontiers in Pharmacology, 9(1253:1-25. doi.org/10.3389/fphar.2018.01253.
38. Zagórska, DM., Furman, TD., Dudra, JM., Zygo, K., Stanisławek, A., Kapka-S L.(2017). Evaluation of clinical effectiveness of Aloe vera – a review. J Pre-Clin Clin Res,11(1): 86–93. doi: 10.26444/jpccr/74577.
39. Worthington, H.V., Clarkson, J.E., Bryan, G., Furness,S., Glenny, A.M., Littlewood, A., McCabe, MG., Meyer, S., Khalid, T.(2010). Interventions for preventing oral mucositis for patients with cancer receiving treatment. Cochrane Database Syst Rev, 8(12):CD000978. doi: 10.1002/14651858.CD000978.pub3.