Enjuagues Orales de Cúrcuma En El Tratamiento de La Mucositis Oral: Avances, Mecanismos y Retos
DOI:
https://doi.org/10.36489/saudecoletiva.2025v15i93p14881-14894Palabras clave:
Curcuma, Curcumina, Estomatitis, Antisépticos Bucales, QuimioradioterapiaResumen
Objetivo: evaluar la eficacia de los enjuagues orales con cúrcuma/curcumina en la prevención y reducción de la mucositis oral en pacientes sometidos a quimiorradioterapia. Métodos: se realizó una búsqueda sistemática en bases de datos y literatura gris, considerando estudios publicados entre 2014 y octubre de 2024. Se seleccionaron ensayos clínicos y revisiones sobre la eficacia de los enjuagues con curcumina, excluyendo otras formulaciones. Resultados y conclusión: se incluyeron 14 estudios, que indicaron que los enjuagues con curcumina retrasan la mucositis y reducen su gravedad, aunque no previenen totalmente su incidencia. Son seguros, fáciles de aplicar y bien tolerados. Sin embargo, los estudios presentan limitaciones metodológicas, como muestras pequeñas y variabilidad en las dosis. Se requieren ensayos clínicos más robustos para confirmar estos hallazgos y optimizar la biodisponibilidad de la curcumina, mejorando su eficacia en el tratamiento de la mucositis oral.
Citas
Sio TT, Le-Rademacher JG, Leenstra JL, Loprinzi CL, Rine G, Curtis A, et al. Effect of Doxepin Mouthwash or Diphenhydramine-Lidocaine-Antacid Mouthwash vs Placebo on Radiotherapy-Related Oral Mucositis Pain: The Alliance A221304 Randomized Clinical Trial. JAMA. 2019;321(15):1481-1490.
Braga FTMM, Santos ACF, Bueno PCP, Silveira RCCP, Santos CB, Bastos JK, et al. Use of Chamomilla recutita in the Prevention and Treatment of Oral Mucositis in Patients Undergoing Hematopoietic Stem Cell Transplantation. Cancer Nurs. 2015;38(4):322-329.
de Vries J, Poelman A, Sidorenkov G, Festen S, de Bock GH, Langendijk JA, et al. The association of frailty and outcomes of geriatric assessment with acute radiation-induced toxicity in patients with head and neck cancer. Oral Oncol.2022;130:105933.
Niikura N, Ota Y, Hayashi N, Naito M, Kashiwabara K, Watanabe K, et al. Evaluation of oral care to prevent oral mucositis in estrogen receptor-positive metastatic breast cancer patients treated with everolimus (Oral Care-BC): randomized controlled phase III trial. Jpn J Clin Oncol. 2016;46(9):879-82.
Sonis ST. Mucositis: The impact, biology and therapeutic opportunities of oral mucositis. Oral Oncol. 2009;45(12):1015-20.
Galloway T, Amdur RJ. Management and prevention of complications during initial treatment of head and neck cancer: UptoDate. 2024out. https://medilib.ir/uptodate/show/3408.
Armelin MVL, Jurado SR, Saraiva KVO, Corazza AV, Silva GD, Sanchez A. O uso do laser de baixa potência por enfermeiro no tratamento de lesões cutâneas e orais. Nursing (São Paulo). 2019;22(253):3006-10.
dos Santos Filho EX, da Silva ACG, de Ávila RI, Batista AC, Marreto RN, Lima EM, et al. Chemopreventive effects of FITOPROT against 5-fluorouracil-induced toxicity in HaCaT cells. Life Sci. 2018; 193:300-8.
Baharvand M, Jafari S, Mortazavi H. Herbs in Oral Mucositis. J Clin Diagn Res. 2017;11(3):ZE05-ZE11.
Huang X, Zheng Y, Zhang X, Mai H, Zeng L, Liu X, et al. Diagnosis and Management of Skull Base Osteoradionecrosis After Radiotherapy for Nasopharyngeal Carcinoma. Laryngoscope. 2006;116(9):1626-31.
Nagpal M, Sood S. Role of curcumin in systemic and oral health: An overview. J Nat Sci Biol Med. 2013; 4(1): 3-7
Rao S, Dinkar C, Vaishnav LK, Rao P, Rai MP, Fayad R, et al. The Indian Spice Turmeric Delays and Mitigates Radiation-Induced Oral Mucositis in Patients Undergoing Treatment for Head and Neck Cancer. Integr Cancer Ther. 2014;13(3):201-10.
Saldanha SP. A Comparative Study to Assess the Effectiveness of Turmeric Mouth Wash versus Saline Mouth Wash on Treatment Induced Oral Mucositis (Tiom) in a Selected Hospital at Mangalore. J Clin Res Bioeth. 2014;5(6).
Shah S, Rath H, Sharma G, Senapati SN, Mishra E. Effectiveness of curcumin mouthwash on radiation-induced oral mucositis among head and neck cancer patients: A triple-blind, pilot randomised controlled trial. Indian J Dent Res. 2020;31(5):718-27.
Thomas PL, Kang HK, Rishi KS. Randomized Control Study of the Effects of Turmeric Mouthwash on Oral Health Status, Treatment-Induced Mucositis, and Associated Oral Dysfunctions Among Patients with Head and Neck Cancer. Cancer Nurs. 2023;46(1):36-44.
Ramezani V, Ghadirian S, Shabani M, Boroumand MA, Daneshvar R, Saghafi F. Efficacy of curcumin for amelioration of radiotherapy-induced oral mucositis: a preliminary randomized controlled clinical trial. BMC Cancer. 2023;23(1):354.
Dharman S, G Marahathavalli, Shanmugasundaram K, Sampath RK. A Systematic Review and Meta-Analysis on the Efficacy of Curcumin/Turmeric for the Prevention and Amelioration of Radiotherapy/Radiochemotherapy Induced Oral Mucositis in Head and Neck Cancer Patients. Asian Pac J Cancer Prev. 2021;22(6):1671-84.
Zhang X, Sun D, Qin N, Liu M, Zhang J, Li X. Comparative prevention potential of 10 mouthwashes on intolerable oral mucositis in cancer patients: A Bayesian network analysis. Oral Oncol. 2020; 107:104751.
Akbari S, Kariznavi E, Jannati M, Elyasi S, Tayarani-Najaran Z. Curcumin as a preventive or therapeutic measure for chemotherapy and radiotherapy induced adverse reaction: A comprehensive review. Food Chem Toxicol. 2020; 145:111699.
Hegde M, Girisa S, BharathwajChetty B, Vishwa R, Kunnumakkara AB. Curcumin Formulations for Better Bioavailability: What We Learned from Clinical Trials Thus Far? ACS Omega. 2023;8(12):10713-46.
Yu YT, Deng JL, Jin XR, Zhang ZZ, Zhang XH, Zhou X. Effects of 9 oral care solutions on the prevention of oral mucositis: a network meta-analysis of randomized controlled trials. Medicine (Baltimore). 2020;99(16):e19661.
Normando AGC, de Menêses AG, de Toledo IP, Borges GÁ, de Lima CL, Dos Reis PED, et al. Effects of turmeric and curcumin on oral mucositis: A systematic review. Phytother Res. 2019;33(5):1318-29.
Wahyuni IS, Sufiawati I, Nittayananta W, Puspitasari IM, Levita J. Efficacy and safety of plant-based therapy on recurrent aphthous stomatitis and oral mucositis in the past decade: a systematic review. J Herbmed Pharmacol. 2021;10(2):179-87.
Wu CF, Wu HJ, Shih CL, Yeh TP, Ma WF. Efficacy of turmeric in the treatment of oral mucositis in patients with head and neck cancer after radiotherapy or chemoradiotherapy: a systematic review and meta-analysis. Front Pharmacol. 2024; 15:1363202.
Zhang L, Tang G, Wei Z. Prophylactic and Therapeutic Effects of Curcumin on Treatment-Induced Oral Mucositis in Patients with Head and Neck Cancer: A Meta-Analysis of Randomized Controlled Trials. Nutr Cancer.2021;73(5):740-9.
Freier K, Engel M, Lindel K, Flechtenmacher C, Mühling J, Hassfeld S, et al. Neoadjuvant concurrent radiochemotherapy followed by surgery in advanced oral squamous cell carcinoma (OSCC): A retrospective analysis of 207 patients. Oral Oncol 2008; 44(2): 116–23.
Sonis ST. Oral mucositis. Anticancer Drugs. 2011;22(7):607-12.
World Health Organization. WHO handbook for reporting results of cancer treatment. 1979;48: https://iris.who.int/handle/10665/37200.
Sonis ST. The biologic role for nuclear factor-kappaB in disease and its potential involvement in mucosal injury associated with anti-neoplastic therapy. Crit Rev Oral Biol Med. 2002;13(5):380-9.
Lüer S, Troller R, Jetter M, Spaniol V, Aebi C. Topical curcumin can inhibit deleterious effects of upper respiratory tract bacteria on human oropharyngeal cells in vitro: potential role for patients with cancer therapy-induced mucositis? Support Care Cancer. 2011;19(6):799-806.
Elad S, Meidan I, Sellam G, Simaan S, Zeevi I, Waldman E, et al. Topical curcumin for the prevention of oral mucositis in pediatric patients: case series. Altern Ther Health Med. 2013;19(3):21-4.
Zhang Y, Huang Y, Li Z, Wu H, Zou B, Xu Y. Exploring Natural Products as Radioprotective Agents for Cancer Therapy: Mechanisms, Challenges, and Opportunities. Cancers (Basel). 2023;15(14):3585.
Dulbecco P, Savarino V. Therapeutic potential of curcumin in digestive diseases. World J Gastroenterol. 2013;19(48):9256-70.
Soni TP, Gupta AK, Sharma LM, Singhal H, Sharma S, Gothwal RS. A Randomized, Placebo-Controlled Study to Evaluate the Effect of Bio-Enhanced Turmeric Formulation on Radiation-Induced Oral Mucositis. ORL J Otorhinolaryngol Relat Spec. 2022;84(2):103-13.