Skip to main content
Log in

Komplementärmedizinische Behandlungsansätze bei oraler Mukositis und Xerostomie

Complementary medical treatment approaches for oral mucositis and xerostomia

  • Integrative Onkologie
  • Published:
Der Onkologe Aims and scope

Zusammenfassung

Hintergrund

Patienten mit Tumoren im Kopf-Hals-Bereich leiden oft an einer iatrogenen Mukositis und Mundtrockenheit, die auch langfristig zu einer erheblichen Beeinträchtigung der Ernährung führen können.

Methode

Es erfolgte eine Zusammenstellung klinisch bereits geprüfter komplementärmedizinischer Behandlungsansätze und eine ergänzende Auflistung phytotherapeutischer Möglichkeiten aus dem Kanon der Traditionellen Europäischen Medizin.

Ergebnisse

Sowohl zur Behandlung der akuten Stomatitis und Mukositis als auch der akuten Xerostomie gibt es eine Reihe medikamentöser und nichtmedikamentöser Behandlungsansätze, die der Onkologe kennen und beachten sollte. Europäische Phytotherapeutika sind bisher relativ selten einer klinischen Prüfung unterzogen worden.

Schlussfolgerungen

Die Nutzung komplementärmedizinischer Maßnahmen kann für die Behandlung der Mukositis und der Xerostomie im Einzelfall sinnvoll sein. Forschungsbedarf besteht insbesondere auf dem Gebiet der traditionellen europäischen Heilkräuter, da diese eine hohe Akzeptanz bei den Patienten haben.

Abstract

Background

Patients with tumors in the head and neck region often suffer from iatrogenic mucositis and xerostomia. Both symptoms can have a severe long-term effect on patients’ nutritional status.

Method

Compilation of several approaches of complementary alternative medicine (CAM), which have already been tested in clinical studies. Additionally, known phytopharmaceutical remedies from the canon of traditional European medicine are listed.

Results

There are several drug-based and non-medicamentous treatment approaches for treating acute stomatitis/mucositis as well as acute xerostomia, which an oncologist should know and consider for treatment. So far there have only been very few clinical studies investigating traditional European phytopharmaceutical drugs.

Conclusions

The use of CAM for treating mucositis and xerostomia may be reasonable in individual cases. More in-depth investigations on the effects of traditional European medicinal herbs are required as patients show a high consumer acceptance for these remedies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1

Literatur

  1. de Almeida ACR, de Sousa Lima FCM, do Vasconcelos EBC (2018) Is bromelain an effective drug for the control of pain and inflammation associated with impacted third molar surgery? Systematic review and meta-analysis. Int J Oral Maxillofac Surg. https://doi.org/10.1016/j.ijom.2018.07.028

    Article  PubMed  Google Scholar 

  2. Ameri A, Heydarirad G, Rezaeizadeh H et al (2016) Evaluation of efficacy of an herbal compound on dry mouth in patients with head and neck cancers: a randomized clinical trial. J Evid Based Complementary Altern Med 21:30–33. https://doi.org/10.1177/2156587215590232

    Article  CAS  PubMed  Google Scholar 

  3. Atashi V, Yazdannik A, Mahjobipoor H et al (2018) The effects of aloe vera-peppermint (Veramin) moisturizing gel on mouth dryness and oral health among patients hospitalized in intensive care units: a triple-blind randomized placebo-controlled trial. J Res Pharm Pract 7:104–110. https://doi.org/10.4103/jrpp.JRPP_18_21

    Article  PubMed  PubMed Central  Google Scholar 

  4. Aulbert E (2012) Lehrbuch der Palliativmedizin. Schattauer, Stuttgart

    Google Scholar 

  5. Bardy J, Molassiotis A, Ryder WD et al (2012) A double-blind, placebo-controlled, randomised trial of active manuka honey and standard oral care for radiation-induced oral mucositis. Br J Oral Maxillofac Surg 50:221–226. https://doi.org/10.1016/j.bjoms.2011.03.005

    Article  PubMed  Google Scholar 

  6. Barrach RH, de Souza MP, da Silva DPC et al (2015) Oral changes in individuals undergoing hematopoietic stem cell transplantation. Braz J Otorhinolaryngol 81:141–147. https://doi.org/10.1016/j.bjorl.2014.04.004

    Article  PubMed  Google Scholar 

  7. Blanco K, Inada N, Bagnato V (2018) Study of new option for treatment of streptocoocal pharyngotonsillitis

    Google Scholar 

  8. do Braga FPF, Lemos CA Junior, Alves FA, Migliari DA (2011) Acupuncture for the prevention of radiation-induced xerostomia in patients with head and neck cancer. Braz Oral Res 25:180–185

    Article  Google Scholar 

  9. Büntzel J, Krauß T, Büntzel H et al (2012) Nutritional parameters for patients with head and neck cancer. Anticancer Res 32:2119–2123

    PubMed  Google Scholar 

  10. Cerchietti LCA, Navigante AH, Lutteral MA et al (2006) Double-blinded, placebo-controlled trial on intravenous L‑alanyl-L-glutamine in the incidence of oral mucositis following chemoradiotherapy in patients with head-and-neck cancer. Int J Radiat Oncol Biol Phys 65:1330–1337. https://doi.org/10.1016/j.ijrobp.2006.03.042

    Article  CAS  PubMed  Google Scholar 

  11. Charalambous A, Lambrinou E, Katodritis N et al (2017) The effectiveness of thyme honey for the management of treatment-induced xerostomia in head and neck cancer patients: A feasibility randomized control trial. Eur J Oncol Nurs 27:1–8. https://doi.org/10.1016/j.ejon.2017.01.001

    Article  PubMed  Google Scholar 

  12. Crowder SL, Douglas KG, Pepino YM et al (2018) Nutrition impact symptoms and associated outcomes in post-chemoradiotherapy head and neck cancer survivors: a systematic review. J Cancer Surviv Res Pract 12:479–494. https://doi.org/10.1007/s11764-018-0687-7

    Article  Google Scholar 

  13. Deng G, Hou BL, Holodny AI, Cassileth BR (2008) Functional magnetic resonance imaging (fMRI) changes and saliva production associated with acupuncture at LI-2 acupuncture point: a randomized controlled study. Bmc Complement Altern Med 8:37. https://doi.org/10.1186/1472-6882-8-37

    Article  PubMed  PubMed Central  Google Scholar 

  14. Deutsche Gesellschaft für Rheumatologie e. V. (2018) https://dgrh.de/Start/Publikationen/Empfehlungen/Krankheitsbezogene-Therapie/Sj%C3%B6gren-Syndrom.html. Zugegriffen: 11. Nov. 2018

  15. Färber S, Meyer A (2016) Aromaöle für die Hausapotheke: Naturdüfte kennen und richtig anwenden. Kosmos, Stuttgart

    Google Scholar 

  16. Hensel W (2014) Welche Heilpflanze ist das? : [über 350 Heilpflanzenarten aus ganz Europa kennenlernen und sicher bestimmen]. Kosmos, Stuttgart

    Google Scholar 

  17. Heydarirad G, Rezaeizadeh H, Choopani R et al (2017) Efficacy of a traditional Persian medicine preparation for radiation-induced xerostomia: a randomized, open-label, active-controlled trial. J Integr Med 15:201–208. https://doi.org/10.1016/S2095-4964(17)60333-9

    Article  PubMed  Google Scholar 

  18. Jinbu Y, Demitsu T (2014) Oral ulcerations due to drug medications. Jpn Dent Sci Rev 50:40–46. https://doi.org/10.1016/j.jdsr.2013.12.001

    Article  Google Scholar 

  19. Lalla RV, Bowen J, Barasch A et al (2014) MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer 120:1453–1461. https://doi.org/10.1002/cncr.28592

    Article  PubMed  PubMed Central  Google Scholar 

  20. Leitlinienprogramm Onkologie (2018) Supportive Therapie. https://www.leitlinienprogramm-onkologie.de/leitlinien/supportive-therapie/. Zugegriffen: 11. Nov. 2018

    Google Scholar 

  21. Marucci L, Farneti A, Di Ridolfi P et al (2017) Double-blind randomized phase III study comparing a mixture of natural agents versus placebo in the prevention of acute mucositis during chemoradiotherapy for head and neck cancer. Head Neck 39:1761–1769. https://doi.org/10.1002/hed.24832

    Article  PubMed  Google Scholar 

  22. Mayer JG, Uehleke B, Saum K (2013) „Das“ große Buch der Klosterheilkunde: neues Wissen über die Wirkung der Heilpflanzen ; vorbeugen, behandeln und heilen. Zabert Sandmann, München

    Google Scholar 

  23. Migliorati C, Hewson I, Lalla RV et al (2013) Systematic review of laser and other light therapy for the management of oral mucositis in cancer patients. Support Care Cancer 21:333–341. https://doi.org/10.1007/s00520-012-1605-6

    Article  PubMed  Google Scholar 

  24. Milani A‑MC, Macedo C‑LR, Bello M‑DC et al (2018) A successful approach to conrol burning mouth syndrome using matricaria recutita and cognitive therapy. J Clin Exp Dent 10:e499–e501. https://doi.org/10.4317/jced.54686

    Article  PubMed  PubMed Central  Google Scholar 

  25. Mohsin AHB, Reddy SV, Kumar MP, Samee S (2017) Aloe vera for dry mouth denture patients—palliative therapy. J Clin Diagn Res 11:ZC20–ZC23. https://doi.org/10.7860/JCDR/2017/25084.10036

    Article  PubMed  PubMed Central  Google Scholar 

  26. Nagi R, Patil DJ, Rakesh N et al (2018) Natural agents in the management of oral mucositis in cancer patients-systematic review. J Oral Biol Craniofacial Res 8:245–254. https://doi.org/10.1016/j.jobcr.2017.12.003

    Article  Google Scholar 

  27. Niederegger O, Mayr C (2005) Hausbuch der Südtiroler Heilkräuter: Gesundheit aus der Natur Bd. 1. Athesia Tappeiner Verlag, Bolzano

    Google Scholar 

  28. Nik Nabil WN, Lim RJ, Chan SY et al (2018) A systematic review on Chinese herbal treatment for radiotherapy-induced xerostomia in head and neck cancer patients. Complement Ther Clin Pract 30:6–13. https://doi.org/10.1016/j.ctcp.2017.10.004

    Article  PubMed  Google Scholar 

  29. Paim ÉD, Macagnan FE, Martins VB et al (2018) Transcutaneous Electrical Nerve Stimulation (TENS) on hyposalivation induced by radiotherapy in the head and neck region: a preliminary study. Codas 30:e20170143. https://doi.org/10.1590/2317-1782/20182017143

    Article  PubMed  Google Scholar 

  30. Park B, Noh H, Choi D‑J (2017) Herbal medicine for Xerostomia in cancer patients: a systematic review of randomized controlled trials. Integr Cancer Ther 17:179–191. https://doi.org/10.1177/1534735417728336

    Article  PubMed  PubMed Central  Google Scholar 

  31. Peterson DE, Jones JB, Petit RG (2007) Randomized, placebo-controlled trial of Saforis for prevention and treatment of oral mucositis in breast cancer patients receiving anthracycline-based chemotherapy. Cancer 109:322–331. https://doi.org/10.1002/cncr.22384

    Article  CAS  PubMed  Google Scholar 

  32. Pfister DG, Cassileth BR, Deng GE et al (2010) Acupuncture for pain and dysfunction after neck dissection: results of a randomized controlled trial. J Clin Oncol Off J Am Soc Clin Oncol 28:2565–2570. https://doi.org/10.1200/JCO.2009.26.9860

    Article  Google Scholar 

  33. Raeessi MA, Raeessi N, Panahi Y et al (2014) “Coffee plus honey” versus “topical steroid” in the treatment of chemotherapy-induced oral mucositis: a randomised controlled trial. Bmc Complement Altern Med 14:293. https://doi.org/10.1186/1472-6882-14-293

    Article  PubMed  PubMed Central  Google Scholar 

  34. Ribeiro da Silva VC, da Motta Silveira FM, Barbosa Monteiro MG et al (2018) Photodynamic therapy for treatment of oral mucositis: pilot study with pediatric patients undergoing chemotherapy. Photodiagnosis Photodyn Ther 21:115–120. https://doi.org/10.1016/j.pdpdt.2017.11.010

    Article  PubMed  Google Scholar 

  35. Rubenstein EB, Peterson DE, Schubert M et al (2004) Clinical practice guidelines for the prevention and treatment of cancer therapy–induced oral and gastrointestinal mucositis. Cancer 100:2026–2046. https://doi.org/10.1002/cncr.20163

    Article  PubMed  Google Scholar 

  36. Schiff E, Ben-Arye E (2011) Complementary therapies for side effects of chemotherapy and radiotherapy in the upper gastrointestinal system. Eur J Integr Med 3:11–16. https://doi.org/10.1016/j.eujim.2011.02.006

    Article  Google Scholar 

  37. Schiff E, Mogilner JG, Sella E et al (2009) Hypnosis for postradiation xerostomia in head and neck cancer patients: a pilot study. J Pain Symptom Manage 37:1086–1092.e1. https://doi.org/10.1016/j.jpainsymman.2008.07.005

    Article  PubMed  Google Scholar 

  38. Sherlock S, Way M, Tabah A (2018) Hyperbaric oxygen treatment for the management of radiation-induced xerostomia. J Med Imaging Radiat Oncol. https://doi.org/10.1111/1754-9485.12789

    Article  PubMed  Google Scholar 

  39. Stubbe CE, Valero M (2013) Complementary strategies for the management of radiation therapy side effects. J Adv Pract Oncol 4:219–231

    PubMed  PubMed Central  Google Scholar 

  40. Villa A, Connell CL, Abati S (2015) Diagnosis and management of xerostomia and hyposalivation. Ther Clin Risk Manag 11:45. https://doi.org/10.2147/TCRM.S76282

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Judith Büntzel.

Ethics declarations

Interessenkonflikt

J. Büntzel, J. Hübner und J. Büntzel geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Büntzel, J., Hübner, J. & Büntzel, J. Komplementärmedizinische Behandlungsansätze bei oraler Mukositis und Xerostomie. Onkologe 25, 269–274 (2019). https://doi.org/10.1007/s00761-019-0521-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00761-019-0521-5

Schlüsselwörter

Keywords

Navigation