Efficacy of benzydamine oral rinse in prevention and management of radiation-induced oral mucositis: A double-blind placebo-controlled randomized clinical trial.

AIM: Several studies have demonstrated positive effects of benzydamine oral rinse in prevention of radiation-induced oral mucositis. The aim of this study was to assess the efficacy of this medication in reducing the signs and symptoms of oral mucositis in patients receiving radiotherapy for head and neck cancer. METHODS: Fifty-one patients with head and neck carcinoma 2012 received external beam radiotherapy for 5 days/week to total planned cumulative radiotherapy doses of at least 5000 cGy. Patients were randomized to treatment with either benzydamine oral rinse or placebo, initiated the day before radiotherapy and continued for 2 weeks after the end of treatment. Oral cavity was divided into 14 anatomical sites and relevant sites were examined weekly, with a score given to each site based on the degree of mucositis using a 4-point scale, and then a "mean mucositis score" was calculated. RESULTS: Up to the end of third week, two groups did not show any difference in the severity of mucositis. However, by the end of week 4, the mean score of placebo group was more than that of treatment group (1.81 vs 1.27, P=0.001). This trend continued to end of week 7 (1.98 vs 1.43, P=0.001). CONCLUSION: Benzydamine oral rinse can be considered as an effective, safe and well-tolerated medication for prevention of radiation-induced oral mucositis and alleviating its symptoms.

Comparing cystatin C changes as a measure of renal function before and after radiotherapy in patients with stomach cancer.

The objective of this study was to determine and compare cystatin C changes before and after radiotherapy in patients with stomach cancer who were candidate for radiotherapy. This study was conducted as a prospective cohort one. Eighteen patients with definite diagnosis of stomach cancer under treatment by radiotherapy who presented to Radiotherapy-Oncology Center of Imam Hossein Hospital, Tehran-Iran, and the treatment in all cases was simultaneous chemoradiation with Xeloda were included. In all patients before radiotherapy and after radiotherapy serum creatinine (Cr) and cystatin C were measured simultaneously. Mean cystatin level before treatment (1.2 ± 0.4) was significantly lower than that of post-treatment (1.6 ± 0.36), (P=0.001). Serum Cr level before treatment was 1.15 ± 0.33 and after radiotherapy was 1.08 ± 0.24 and did not show significant difference. Glomerular filtration rate (GFR) of the patients before radiotherapy was -46.8 ± 21.0 and after radiotherapy was 43.8 ± 15.8 that did not have significant difference (P=0.146) and also blood urea nitrogen (BUN) before radiotherapy was 20.72 ± 3.7 and 20 ± 6.38 after radiotherapy that did not have significant difference (P=0.6). Comparison of the cystatin C difference with total radiation dose of the kidneys that are put in three dose groups in radiotherapy field had association that in dose of less that 18 gray (Gy) the cystatin C change showed significant and positive association (P=0.027; r=0.52) and about 18-24 Gy the cystatin C difference showed significant and negative association (P=0.023, r=-0.53). It seems that for evaluating the renal function, serum cystatin C measurement is preferable than serum Cr. level.

Prognostic Value of Promoter Hypermethylation of Retinoic Acid Receptor Beta (RARB) and CDKN2 (p16/MTS1) in Prostate Cancer.

OBJECTIVE: The molecular mechanism of prostate cancer is poorly understood. The aim of the study was to investigate the prevalence and prognostic value of promoter hypermethylation of retinoic acid receptor beta (RARB) and p16 among benign prostatic hyperplasia (BPH) and prostate cancer patients. METHODS: In this case-control study, 63 patients were included in three groups; 21 with BPH as the control group, 21 with prostate cancer and good prognostic factors (based on prostate-specific antigen, Gleason score and stage) as good prognosis group, and 21 with prostate cancer and poor prognostic features as poor prognosis group. The prostate biopsy specimen of each individual was examined for hypermethylation of RARB and p16 promoters by methylation specific PCR (MSPCR). RESULTS: Seven (33.3%) patients with good prognosis and 15 (71.4%) patients with poor prognosis were positive for RARB methylation, which were significantly higher than controls (P<0.0001). p16 promoter methylation was shown in 19.0% and 47.6% patients with good and poor prognosis, respectively. The RARB and p16 promoter methylation in the poor prognosis group was significantly higher than that in the good prognosis group (P =0.02 for RARB and P<0.0001 for p16). CONCLUSION: Hypermethylation of RARB and p16 promoters may predict prognosis in prostate cancer.