Effects of herbal medicine for xerostomia in head and neck cancer patients: an observational study in a tertiary cancer hospital.

PURPOSE: More than 80% head and neck cancer patients endured radiotherapy-induced xerostomia which impacts their quality of life (QoL). This observational study evaluated the effect of herbal treatment on head and neck cancer patients' xerostomia and QoL. METHODS: Head and neck cancer patients were recruited from July 2016 till March 2017 at National Cancer Institute, Ministry of Health, Malaysia. All study participants continued their standard oncology surveillance. Treatment group participants additionally received Chinese herbal treatment. The assessments included unstimulated salivary flow rate (USFR), stimulated salivary flow rate (SSFR), and QoL questionnaire. RESULTS: Of 42 recruited participants, 28 were in the treatment group and 14 were in the control group. Participants were mainly Chinese (71.4%), stage III cancer (40.5%), and had nasopharynx cancer (76.2%). The commonly used single herbs were Wu Mei, San Qi, and Tian Hua Fen. Sha Shen Mai Dong Tang, Liu Wei Di Huang Wan, and Gan Lu Yin were the frequently prescribed herbal formulas. The baseline characteristics, USFR, SSFR, and QoL between control and treatment groups were comparable (p > 0.05). USFR between control and treatment groups were similar throughout the 6-month study period. SSFR for the treatment group significantly improved from 0.15 ± 0.28 ml/min (baseline) to 0.32 ± 0.22 ml/min (p = 0.04; at the 3rd month) and subsequently achieved 0.46 ± 0.23 ml/min (p = 0.001; at the 6th month). The treatment group had better QoL in terms of speech (p = 0.005), eating (p = 0.02), and head and neck pain (p = 0.04) at the 6th month. CONCLUSION: Herbal treatment may improve xerostomia and QoL in post-radiotherapy head and cancer patients.

Association of mild to moderate kidney dysfunction with coronary artery calcification in patients with suspected coronary artery disease.

OBJECTIVES: To report the association between kidney dysfunction and coronary artery calcification (CAC) score (CACS) among patients with clinically suspected coronary artery disease (CAD). METHODS: We prospectively included 1,572 consecutive patients with clinically suspected CAD who underwent ECG-gated cardiac CT scans using 64-multidetector row computed tomography. CACS was quantified using a previously described method. Renal function was assessed by the estimated glomerular filtration rate (eGFR). Ordinal logistic regression and Pearson correlation were used to analyze the association between eGFR and CACS. RESULTS: Patients with higher CACS were older, more had a history of hypertension, diabetes and tobacco use, and they were more likely to have an atherogenic lipid profile, higher systolic blood pressure, diastolic blood pressure, hemoglobin A1c, body mass index and C-reactive protein (CRP) and lower eGFR when compared with those patients without CAC or with lower CACS. The unadjusted correlation coefficient of eGFR and CACS was -0.259 (p < 0.001). This remained significant after adjustment for age, gender, hypertension, diabetes, hyperlipidemia, tobacco use and CRP (R = -0.156, p < 0.001). Ordinal logistic regression analysis showed that age, hypertension, diabetes, CRP and eGFR exerted independent influences on CACS. CONCLUSIONS: Kidney dysfunction was an independent predictor of CACS in patients with clinically suspected CAD. Further prospective multicenter studies are needed to confirm this finding.