THE EFFECTIVENESS OF MELATONIN IN REDUCING PAIN RESULTING FROM RADIATION INDUCED ORAL MUCOSITIS: A RANDOMIZED CLINICAL TRIAL
Elsabbagh, H., Moussa, E., Mahmoud, S., Elsaka, R. (2021). THE EFFECTIVENESS OF MELATONIN IN REDUCING PAIN RESULTING FROM RADIATION INDUCED ORAL MUCOSITIS: A RANDOMIZED CLINICAL TRIAL. EKB Journal Management System, 46(Issue 1), 1-5. doi: 10.21608/adjalexu.2021.144849
Hossam H. Elsabbagh; Eglal Moussa; Sabah A. Mahmoud; Rasha O. Elsaka. "THE EFFECTIVENESS OF MELATONIN IN REDUCING PAIN RESULTING FROM RADIATION INDUCED ORAL MUCOSITIS: A RANDOMIZED CLINICAL TRIAL". EKB Journal Management System, 46, Issue 1, 2021, 1-5. doi: 10.21608/adjalexu.2021.144849
Elsabbagh, H., Moussa, E., Mahmoud, S., Elsaka, R. (2021). 'THE EFFECTIVENESS OF MELATONIN IN REDUCING PAIN RESULTING FROM RADIATION INDUCED ORAL MUCOSITIS: A RANDOMIZED CLINICAL TRIAL', EKB Journal Management System, 46(Issue 1), pp. 1-5. doi: 10.21608/adjalexu.2021.144849
Elsabbagh, H., Moussa, E., Mahmoud, S., Elsaka, R. THE EFFECTIVENESS OF MELATONIN IN REDUCING PAIN RESULTING FROM RADIATION INDUCED ORAL MUCOSITIS: A RANDOMIZED CLINICAL TRIAL. EKB Journal Management System, 2021; 46(Issue 1): 1-5. doi: 10.21608/adjalexu.2021.144849

THE EFFECTIVENESS OF MELATONIN IN REDUCING PAIN RESULTING FROM RADIATION INDUCED ORAL MUCOSITIS: A RANDOMIZED CLINICAL TRIAL

Alexandria Dental Journal
Article 1, Volume 46, Issue 1, April 2021, Page 1-5  XML PDF (144.61 K)
Document Type: Original Article
DOI: 10.21608/adjalexu.2021.144849
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Authors
Hossam H. Elsabbagh email 1; Eglal Moussa2; Sabah A. Mahmoud3; Rasha O. Elsaka4
1Instructor of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology department, Faculty of Dentistry, Alexandria University, Egypt.
2Professor of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology department, Faculty of Dentistry, Alexandria University, Egypt.
3Professor of Medical Biochemistry department, Faculty of Medicine, Alexandria University, Egypt.
4Clinical Oncology and Nuclear Medicine department, Faculty of Medicine, Alexandria University, Egypt
Abstract
BACKGROUND: Oral mucositis is a common side effect of anticancer radiotherapy causing severe ulceration of the mucosal tissues. Recently, melatonin supplements have been proposed as a new therapeutic modality for oral mucositis due to its antioxidant effects, anti-inflammatory, and anti-cancer properties.
OBJECTIVES: evaluation of the effectiveness of melatonin in reducing pain resulting from radiation induced oral mucositis
MATERIALS AND METHODS: Forty patients were randomly assigned to receive either: conventional treatment of oral mucositis, or 20 mg melatonin treatment in combination with the conventional treatment before irradiation, and for six weeks. All patients were evaluated for pain resulting from oral mucositis at three and six weeks after the start of radiotherapy.
RESULTS: Oral mucositis patients in the melatonin group have experienced significantly lower pain scores oral mucositis compared to the control group.
CONCLUSION: Adjuvant melatonin reduced the pain of oral mucositis, and the amount of analgesics used for pain treatment.
Keywords
melatonin; oral mucositis; radiotherapy
References
1.Epstein JB, Schubert MM. Managing pain in mucositis. Seminars in Oncology Nursing. 2004;20:30-7.
2.Vijayalaxmi, Reiter RJ, Tan DX, Herman TS, Thomas CR, Jr. Melatonin as a radioprotective agent: a review. International journal of radiation oncology, biology, physics. 2004;59:639-53.
3.Valko M, Leibfritz D, Moncol J, Cronin MT, Mazur M, Telser J. Free radicals and antioxidants in normal physiological functions and human disease. The international journal of biochemistry & cell biology. 2007;39:44-84.
4.Harris DJ. Cancer treatment-induced mucositis pain: strategies for assessment and management. Ther Clin Risk Manag. 2006;2:251-8.
5.Maria OM, Eliopoulos N, Muanza T. Radiation-Induced Oral Mucositis. Frontiers in oncology. 2017;7:89.
6.Rubenstein EB, Peterson DE, Schubert M, Keefe D, McGuire D, Epstein J, et al. Clinical practice guidelines for the prevention and treatment of cancer therapy-induced oral and gastrointestinal mucositis. Cancer. 2004;100(9 Suppl):2026-46.
7.Sonis ST. Mucositis as a biological process: a new hypothesis for the development of chemotherapy-induced stomatotoxicity. Oral Oncol. 1998;34:39-43.
8.Dodd MJ, Miaskowski C, Shiba GH, Dibble SL, Greenspan D, Macphail L, et al. Risk factors for chemotherapy-induced oral mucositis: dental appliances, oral hygiene, previous oral lesions, and history of smoking. Cancer investigation. 1999;17:278-84.
9.Jham BC, Reis PM, Miranda EL, Lopes RC, Carvalho AL, Scheper MA, et al. Oral health status of 207 head and neck cancer patients before, during and after radiotherapy. Clinical oral investigations. 2008;12:19-24.
10. Raber-Durlacher JE, Elad S, Barasch A. Oral mucositis. Oral oncology. 2010;46:452-6.
11. Villa A, Sonis ST. Mucositis: pathobiology and management. Current opinion in oncology. 2015;27:159-64.
12. Nicolatou-Galitis O, Sarri T, Bowen J, Di Palma M, Kouloulias VE, Niscola P, et al. Systematic review of amifostine for the management of oral mucositis in cancer patients. Support Care Cancer. 2013;21:357-64.
13. Moslehi A, Taghizadeh-Ghehi M, Gholami K, Hadjibabaie M, Jahangard-Rafsanjani Z, Sarayani A, et al. N-acetyl cysteine for prevention of oral mucositis in hematopoietic SCT: a double-blind, randomized, placebo-controlled trial. Bone marrow transplantation. 2014;49:818-23.
14. Hardeland R, Pandi-Perumal SR, Cardinali DP. Melatonin. The international journal of biochemistry & cell biology. 2006;38:313-6.
15. Abdel Moneim AE, Ortiz F, Leonardo-Mendonca RC, Vergano-Villodres R, Guerrero-Martinez JA, Lopez LC, et al. Protective effects of melatonin against oxidative damage induced by Egyptian cobra (Naja haje) crude venom in rats. Acta tropica. 2015;143:58-65.
16. Reiter RJ, Melchiorri D, Sewerynek E, Poeggeler B, Barlow-Walden L, Chuang J, et al. A review of the evidence supporting melatonin's role as an antioxidant. J Pineal Res. 1995;18:1-11.

17. Marshall KA, Reiter RJ, Poeggeler B, Aruoma OI, Halliwell B. Evaluation of the antioxidant activity of melatonin in vitro. Free radical biology & medicine. 1996;21:307-15.
18. Vijayalaxmi, Meltz ML, Reiter RJ, Herman TS, Kumar KS. Melatonin and protection from whole-body irradiation: survival studies in mice. Mutation research. 1999;425:21-7.
19. Abdel Moneim AE, Guerra-Librero A, Florido J, Shen YQ, Fernandez-Gil B, Acuna-Castroviejo D, et al. Oral Mucositis: Melatonin Gel an Effective New Treatment. Int J Mol Sci. 2017;18.
20. Vijayalaxmi, Reiter RJ, Herman TS, Meltz ML. Melatonin and radioprotection from genetic damage: in vivo/in vitro studies with human volunteers. Mutation research. 1996;371:221-8.
21. Vijayalaxmi, Reiter RJ, Herman TS, Meltz ML. Melatonin reduces gamma radiation-induced primary DNA damage in human blood lymphocytes. Mutation research. 1998;397:203-8.
22. Wang YM, Jin BZ, Ai F, Duan CH, Lu YZ, Dong TF, et al. The efficacy and safety of melatonin in concurrent chemotherapy or radiotherapy for solid tumors: a meta-analysis of randomized controlled trials. Cancer Chemother Pharmacol. 2012;69:1213-20.
23. Mihandoost E, Shirazi A, Mahdavi SR, Aliasgharzadeh A. Can melatonin help us in radiation oncology treatments? Biomed Res Int. 2014;2014:578137.
24. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. Jama. 2013;310:2191-4.
25. Moher D, Hopewell S, Schulz KF, Montori V, Gotzsche PC, Devereaux PJ, et al. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c869.
26. Killeen PR. An Alternative to Null-Hypothesis Significance Tests. Psychological science. 2005;16:345-53.
27. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior research methods. 2007;39:175-91.
28. Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMC medicine. 2010;8:18.
29. McGuire DB, Correa ME, Johnson J, Wienandts P. The role of basic oral care and good clinical practice principles in the management of oral mucositis. Support Care Cancer. 2006;14:541-7.
30. T Perchyonok V, Zhang S, Oberholzer T. Novel melatonin-chitosan hydrogels as suitable oral bio-drug delivery systems to fight oral mucositis: Synergy of antioxidants and bioactives in action. Current Organic Chemistry. 2012;16:2430-6.
31. Yu C-X, Zhu C-B, Xu S-F, Cao X-D, Wu G-C. The analgesic effects of peripheral and central administration of melatonin in rats. European journal of pharmacology. 2000;403:49-53.
32. Naguib M, Hammond D, Schmid III P, Baker M, Cutkomp J, Queral L, et al. Pharmacological effects of intravenous melatonin: comparative studies with thiopental and propofol. British journal of anaesthesia. 2003;90:504-7.
33. El-Shenawy SM, Abdel-Salam OM, Baiuomy AR, El-Batran S, Arbid MS. Studies on the anti-inflammatory and anti-nociceptive effects of melatonin in the rat. Pharmacological research. 2002;46:235-43.
34. Alstadhaug KB, Odeh F, Salvesen R, Bekkelund SI. Prophylaxis of migraine with melatonin: a randomized controlled trial. Neurology. 2010;75:1527-32.
35. Mozaffari S, Rahimi R, Abdollahi M. Implications of melatonin therapy in irritable bowel syndrome: a systematic review. Current pharmaceutical design. 2010;16:3646-55.
36. Wilhelmsen M, Amirian I, Reiter RJ, Rosenberg J, Gögenur I. Analgesic effects of melatonin: a review of current evidence from experimental and clinical studies. Journal of Pineal Research. 2011;51:270-7.
37. Stefani LC, Muller S, Torres IL, Razzolini B, Rozisky JR, Fregni F, et al. A Phase II, Randomized, Double-Blind, Placebo Controlled, Dose-Response Trial of the Melatonin Effect on the Pain Threshold of Healthy Subjects. PloS one. 2013;8:e74107.
38. Andersen LP, Werner MU, Rosenberg J, Gogenur I. A systematic review of peri-operative melatonin. Anaesthesia. 2014;69:1163-71.
39. Wang T, Li S-r, Dai X, Peng Y-l, Chen Q, Wang R. Effects of melatonin on orphanin FQ/nociceptin-induced hyperalgesia in mice. Brain research. 2006;1085:43-8.

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