Aloe vera for Prevention of Acute Radiation Proctitis in Colorectal Cancer a Preliminary Randomized, Placebo-Controlled Clinical Trial.

Adeleh Sahebnasagh,Hassan Rezai Ghaleno,Fatemeh Saghafi,Ebrahim Salehifar,Arash Ghasemi,Solomon Habtemariam,Jafar Akbari,Mohammadreza Safdari,Abbas Alipour

doi:10.1007/s12029-021-00597-y

Abstract

To examine the preventive effects of Aloe vera in colorectal cancer patients undergoing radiotherapy. Twenty colorectal cancer patients, who received radiation, were randomized to receive Aloe vera 3% or placebo ointment, 1g twice daily for 6weeks. At weekly visits, acute radiation proctitis (ARP) was evaluated by Radiation Therapy Oncology Group and clinical presentation criteria as the primary endpoint. We also evaluated secondary endpoints of quality of life, psychosocial status, by applying Hospital Anxiety-Depression (HAD) Scale and laboratory measures of quantitative measurement of C-reactive protein (CRP) as a marker for systemic inflammation. There was a significant improvement in the symptom index (before treatment vs. after treatment with Aloe vera) for diarrhea (p=0.029, median score: 0.5 vs. 0.001). The overall primary and secondary outcomes favored Aloe group, while the measures of toxicity did not achieve a statistical significant difference. The lifestyle score improved significantly with A. vera (p=004), and they also had a lower depression score in HAD scale (p=0.008). Furthermore, quantitative CRP decreased significantly during the course of treatment with Aloe vera. The use of topical formulation of Aloe vera 3% diminishes the severity of ARP in colorectal cancer patients.

Highlights

Acute radiation proctitis (ARP) is a common complication of radiation therapy (RT)
The use of topical formulation of Aloe vera 3% diminished the severity of ARP in colorectal cancer patients
ARP symptoms were evaluated by Radiation Therapy Oncology Group (RTOG) and clinical presentation criteria [2]

Summary

Introduction

Acute radiation proctitis (ARP) is a common complication of radiation therapy (RT). This adverse effect in severe cases results in interruption of RT and poor outcome. Aloe vera is an herbal remedy with a well-established history for its therapeutic properties in various disorders. It is well-known for its anti-oxidant, anti-inflammatory, analgesic, antiproliferative, anticarcinogenic and antiaging properties. This plant has been used in radiation-induced skin reactions and proctitis treatment for its anti-inflammatory, anti-oxidant and analgesic properties in previous studies [1, 2]. Acute radiation proctitis (ARP) is a common complication of pelvic radiotherapy (RT) to malignant diseases of lower abdomen and pelvis. The molecular mechanism of ARP is due to an enhanced production of free oxygen species [4]

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