ABSTRACT
Background: Aloe vera has been widely used to treat various conditions such as sunburn or radiation-related dermatitis, mucositis, or esophagitis. It is suggested that Aloe vera may be benefit for radiation-induced mucositis. Objective: To evaluate the efficacy of oral aloe vera juice in the alleviation of radiation induced mucositis in head and neck cancer patients using a double-blind, randomized controlled trial. Methods and materials: Sixty-one eligible head and neck cancer patients, who received conventional radiation therapy at Ramathibodi Hospital, were randomized to receive oral Aloe vera juice or placebo. Mucosal reaction was assessed during the course of radiation using the Radiation Therapy Oncology Group grading system. Results: Patient baseline characteristics were identical in Aloe vera juice and placebo groups except in the gender. The incidence of severe mucositis was significantly lower in the aloe vera group compared with the placebo group (53% vs. 87%, p =0.004). However, there was no significant difference in the time-duration to severe mucositis development. No adverse effects related to the drug were observed. Conclusion: Oral aloe vera juice was beneficial in alleviating the severity of radiation-induced mucositis and without side effects. The Aloe vera juice may be an alternative agent treating radiation-induced mucositis in patients with head and neck cancers.
ABSTRACT
Background: CyberKnife is a frameless image-guided robotic system for stereotactic body radiotherapy. It can deliver an accurate and concentrated radiation beam to intracranial and extracranial targets for benign, malignant and some non-neoplastic conditions. Objective: To report the first hepatocellular carcinoma (HCC) treated with CyberKnife at Ramathibodi Hospital. Patient and methods: A 73- year-old man with a large right lobe hepatocellular carcinoma was treated with CyberKnife with the total dose of 4500 cGy in three fractions. Results: Two weeks after CyberKnife, he developed radiation induced liver damage (RILD). The patient was admitted for observation and supportive treatment. He was discharged with much improvement of symptoms. Abdominal MRI taken 1 and 3 months after the CyberKnife revealed a significant reduction in size of HCC. His serum alpha fetoprotein was also decreased from 833 ng/mLto 12 ng/mL. Conclusion: The present Robotic Radiosurgery was an effective alternative treatment for HCC. Early detection and proper supportive care was very important to decrease the morbidity from this serious radiation.