Oral mucositis is a common complication and a dose limiting toxicity in up to 90% of head & neck cancer patients (HNCP) undergoing radio-chemotherapy.
Several adjuvant agents like folic acid, Vit-E, antibiotic mouth rinse etc. have been tried without remarkable success. Curcumin is known to have antioxidant
and free radical scavenging activity that had shown its radio protective potential in in vitro studies. Objective of this pilot study was to evaluate effects of
curcumin on mucositis in HNCP undergoing radio-chemotherapy. An open labelled controlled trial was conducted, 95 HNCPs in historic control group were given
conventional radio-chemotherapy and 109 HNCP in trial group were given 2 gm of curcumin /day in addition to conventional therapy for two months starting
from 3 days before planned radiation. Mucositis gradation as per WHO oral toxicity scale was done weekly for the whole radio-chemotherapy period.
Incidence of mucositis in each grade, and patient compliance were compared in both control and curcumin treated group by Chi-square test (P ≤ 0.05). There
was a significant decrease in incidence of mucositis from 92% to 51% (P ≤ 0.001) and in grade III and IV mucositis from 51.6% to 12.8% (P≤ 0.001) among
control and curcumin treated group respectively. Patient compliance in terms of completion of scheduled RT dose, increased from 52.6% to 89.0% (P≤0.001).
Curcumin showed a remarkable adjuvant protective activity to radio-chemotherapy in HNCP. So, a well-designed RCT with a long term follow up for prognostic
implications is imperative.