Ayurvedic Drug Triphala in Combination with Providone Iodine Mitigates Radiation-Induced Mucositis in Head and Neck Cancer Patients without Affecting the Tumor Response.

Radiation-induced mucositis is a dose-limiting concern in the treatment of head and neck cancers (HNC). This study was conducted to determine the effectiveness of the Ayurvedic drug Triphala in reducing radiation-induced mucositis and influencing tumour control when combined with providone iodine. Data from patient files of HNC patients who received Triphala in conjunction with iodine or iodine alone over the course of curative radiotherapy (> 60 Gy) from May 2013 to February 2015 were extracted for this retrospective chart based study. Data was subjected to statistical analysis, X2 and unpaired t test using the Statistical Package for Social Sciences (SPSS), version 17 (IBM, Chicago, USA). When compared to iodine alone, the group that utilised Triphala gargling was very efficient in delaying mucositis, the extent of weight loss (p = 0.038), the incidence (p = 0.03), and the number (p = 0.02) of treatment breaks. However, it had no influence on the radiation-induced tumour response. According to the observations, Triphala coupled with iodine was more successful in preventing radiation mucositis, and without affecting the killing of tumour cells than iodine gargle alone. According to the authors, this is the first observation to demonstrate the value of combining providone iodine with Triphala in preventing radiation-induced oral mucositis.

Aqueous Extract of Emblica officinalis Linn (Indian gooseberry) in Combination with Iodine is More Efficacious than Iodine Alone in Mitigating Mucositis in Head and Neck Cancer Patients Undergoing Curative Radiotherapy: Retrospective Observations.

Mucositis is a very painful unavoidable and common side effect in head and neck cancer patients undergoing curative radiotherapy and can affect the planned treatment. In this study, attempt is made at understanding the efficacy of Emblica officinalis Linn (amla) when combined with providone iodine in mitigating radiation-induced mucositis, weight loss and tumor control. This was a retrospective chart based study and was carried out by extracting the data from the files of patients with cancer of head and neck who used amla in combination with iodine or iodine alone during the course of the curative radiotherapy (> 60 Gy). The data was entered in to Microsoft excel and subjected to statistical analysis using SPSS 17 software. The results indicate that when compared with iodine alone, the group where iodine and amla gargling were used was very effective in delaying mucositis, reduced incidence of intolerable mucositis (P = 0.027), quantitative grade of weight loss (P = 0.016), incidence of severe weight loss (P = 0.03) without affecting tumor response. The results suggest that when compared with iodine alone, amla when combined with iodine was more effective in mitigating radiation mucositis and by not interfering with the tumor cell kill. As far as the authors are aware of this is the first study that shows the usefulness of combining iodine with Amla in mitigating radiation-induced mucositis.

Rasayana drugs from the Ayurvedic system of medicine as possible radioprotective agents in cancer treatment.

The use of ionizing radiation, which is the cornerstone of cancer treatment, is compromised by the radiosensitivity of normal tissues. A chemical that can give selective benefit to the normal cells against the deleterious effects of ionizing radiation has been a long-sought goal. However, most of the compounds studied have shown inadequate clinical application owing to their inherent toxicity, undesirable side effects, and high cost. Studies carried out in the past 2 decades have shown that some of the classical Indian Ayurvedic drugs (Amritaprasham, Ashwagandha Rasayana, Brahma Rasayana, Chyavanprasha, Narasimha Rasayana, and Triphala Churna) possess radioprotective effects. In the current review, an attempt is made to summarize the radioprotective observations of these Ayurvedic drugs and the mechanisms responsible for the radioprotective effects.

Scientific validation of the ethnomedicinal properties of the Ayurvedic drug Triphala: a review.

Triphala, a herbal formula composed of the three fruits of Terminalia chebula Retz. (Haritaki, Family: Combretaceae), Terminalia bellirica Roxb. (Bibhitaki, Family: Combretaceae) and Phyllanthus emblica Linn. or Emblica officinalis Gaertn. (Amalaki or the Indian gooseberry, Family: Euphorbiaceae) is considered to be a universal panacea in the traditional Indian system of medicine the Ayurveda. It has been described in the Ayurveda text as a "Rasayana' and to rejuvenat the debilitated organs. Ayurvedic physicians use Triphala for many ailments but most importantly to treat various gastrointestinal disorders. Scientific studies carried out in the past two decades have validated many of the ethnomedicinal claims and researches have shown Triphala to possess free radical scavenging, antioxidant, antiinflammatory, antipyretic, analgesic, antibacterial, antimutagenic, wound healing, anticariogenic, antistress, adaptogenic, hypoglycaemic, anticancer, chemoprotective, radioprotective and chemopreventive effects. Clinical studies have also shown that Triphala was found to have good laxative property, to improve appetite and reduce gastric hyperacidity. Studies have also shown that Triphala was effective in preventing dental caries and that this effect was equal to that of chlorhexidine. The current review addresses the validated pharmacological properties of Triphala and also emphasizes on aspects that need further investigation for its future clinic application.