povidone-iodine and Head-and-Neck-Neoplasms

Radiation-induced oral mucositis is an acute morbidity seen in patients undergoing treatment for head and neck cancers. In this study, we evaluated the efficacy of turmeric in preventing radiation-induced mucositis.. This was a single-blinded, randomized, controlled clinical trial and was conducted with head and neck cancer patients requiring 70 Gy of radiation or chemoradiotherapy (daily radiotherapy plus carboplatin once a week). Eligible patients (n = 80) were randomly assigned to receive either turmeric gargle (n = 40) or povidone-iodine ([n = 40] active comparator condition) during chemo/radiotherapy during the period of treatment. Oral mucositis was assessed using the RTOG (Radiation Therapy Oncology Group) grading system before the start, during, and at the end of the treatment by an investigator unaware of the treatment. The primary endpoint of this study was the incidence of mucositis every week during the 7-week period. The secondary endpoint was the effect of turmeric gargle on the incidence of treatment breaks, loss of scheduled treatment days, and decrease in body weight at the end of the treatment.. This study clearly suggests that when compared with the cohorts using povidone-iodine gargle, the group using turmeric as a mouthwash had delayed and reduced the levels of radiation-induced oral mucositis and was statistically significant at all time points (P< 0.001 toP< 0.0001). Additionally, the cohorts using turmeric had decreased intolerable mucositis (P< 0.001) and lesser incidence of treatment breaks in the first half of the treatment schedule before 4 weeks (P< 0.01) and reduced change in body weight (P< 0.001).. Gargling with turmeric by head and neck cancer patients undergoing radiation therapy provided significant benefit by delaying and reducing the severity of mucositis. Turmeric is readily available, relatively inexpensive, and highly accepted making it useful in cancer treatment.

Topics: Adult; Aged; Anti-Infective Agents, Local; Carboplatin; Chemoradiotherapy; Curcuma; Female; Head and Neck Neoplasms; Humans; Incidence; Male; Middle Aged; Mouthwashes; Povidone-Iodine; Radiation Injuries; Single-Blind Method; Stomatitis; Time Factors

Oral mucositis is a frequent complication of radiochemotherapy. The origin of radiation-induced mucosa lesions is of iatrogenic nature although further development of mucositis is essentially influenced by infection. It can be assumed that disinfection measures should decrease the severity of mucositis induced by radiochemotherapy. Therefore, in a prospective randomised study the efficacy of prophylactic oral rinsing with a disinfection agent was investigated.. An open, randomised, prospective comparative trial was conducted with 40 patients undergoing radiochemotherapy of head and neck region due to malignant disease. The treatment scheme consisted of irradiation to tumor region and adjacent lymph nodes with a total dose of 71.3 Gy and simultaneous chemotherapy with carboplatin (60 mg/m2) on days 1 to 5 and 29 to 34. In all patients, a prophylaxis of mucositis with nystatine, rutosides, panthenol and immunoglobulin was undertaken. In addition, 20 patients rinsed oral cavity 4 times daily with povidone-iodine-solution, the comparative group rinsed with sterile water. Clinical examination of the oral mucosa was performed weekly. Onset, grading and duration of mucositis were used as main variables.. Clinically manifested oral mucositis was observed in 14 patients of the iodine group (mean grading: 1.0) and all 20 patients of the control group (mean grading: 3.0). Total duration (mean) of clinically observed mucositis was 2.75 weeks in treatment patients and 9.25 in control patients. Median AUC (area under curve for grade vs duration) was 2.5 in iodine rinsing patients and 15.75 in control patients. All differences found between the 2 groups were statistically significant. Increased iodine incorporation was not observed. A pathological increase of thyroid hormone levels in the iodine group was not found.. The gained results indicate that incidence, severity and duration of radiochemotherapy-induced mucositis can be significantly reduced by oral rinsing with povidone-iodine performed additionally to the standard prophylaxis scheme.

Topics: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Anti-Infective Agents, Local; Antifungal Agents; Antineoplastic Agents; Carboplatin; Combined Modality Therapy; Female; Head and Neck Neoplasms; Humans; Immunization, Passive; Male; Middle Aged; Mouthwashes; Nystatin; Ointments; Pantothenic Acid; Povidone-Iodine; Prospective Studies; Radiotherapy; Radiotherapy Dosage; Rutin; Stomatitis; Time Factors; Vasodilator Agents

Oral mucositis is a frequent complication of radiochemotherapy. The origin of radiation-induced mucosal lesions is iatrogenic in nature, although further development of mucositis is essentially influenced by infection. It can be assumed that disinfection measures should decrease the severity of mucositis induced by radiochemotherapy. Therefore, in a prospective randomised study the efficacy of prophylactic oral rinsing with a disinfection agent was investigated. A randomised, prospective comparative trial was conducted with 40 patients undergoing radiochemotherapy of the head and neck region because of malignant disease. The treatment scheme consisted of irradiation to the tumour region and adjacent lymph nodes, with a total dose of 71.3 Gy, and simultaneous chemotherapy with carboplatin (60 mg/m2) on days 1-5 and 29-34. In all patients mucositis prophylaxis with nystatin, rutosides, panthenol and immunoglobulin was undertaken. In addition, 20 patients rinsed the oral cavity 4 times daily with povidone-iodine solution, while the group for comparison rinsed with sterile water. Clinical examination of the oral mucosa was performed weekly. Onset, grading and duration of mucositis were used as the main variables. Clinically manifest oral mucositis was observed in 14 patients in the iodine group (mean grading: 1.0) and in all 20 patients in the control group (mean grading: 3.0). The total duration (mean) of clinically observed mucositis was 2.75 weeks in treatment patients and 9.25 weeks in control patients. Median AUC (area under curve for grade vs duration) was 2.5 in the iodine rinsing patients and 15.75 in control patients. All differences found between the two groups were statistically significant. Increased iodine incorporation was not observed. A pathologic rise in thyroid hormone levels was not found in the iodine group. The results obtained indicate that incidence, severity and duration of radiochemotherapy-induced mucositis can be significantly reduced by oral rinsing with povidone-iodine in addition to the standard prophylaxis scheme. It can be concluded that rinsing with povidone-iodine is an easy, cheap and safe prophylactic method and can be recommended as a supportive treatment during antineoplastic treatment of the head and neck region.

Topics: Adult; Aged; Aged, 80 and over; Anti-Infective Agents, Local; Antineoplastic Agents; Chi-Square Distribution; Combined Modality Therapy; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Mouth Mucosa; Povidone-Iodine; Radiotherapy; Reference Values; Stomatitis; Treatment Outcome

In an open study, the efficacy of povidone-iodine in the prophylaxis of mucositis during antineoplastic radiochemotherapy was determined. 40 patients were randomly assigned to a treatment or control group (each 20 patients). All patients received standard prophylaxis of mucositis with nystatin, dexpanthenol, rutoside and immunoglobulin. In addition, the patients of the treatment group performed 4 times daily rinsing with povidone-iodine, the control patients with sterile water. Clinical examination of the oral mucosa was performed weekly during the radiation period and up to 6 weeks after the end of therapy. Oral mucositis was observed in 14 patients of the treatment group (mean grading: 1.0) and in all 20 patients of the control group (mean grading: 3.0). The mean onset of mucositis was after 2.25 weeks in treatment patients and 1.5 weeks in control patients. The mean total duration of mucositis was 2.75 weeks in treatment patients and 9.25 weeks in control patients. The mean AUC values were 2.5 in treatment patients and 15.75 in control patients. All findings were statistically significantly different between the two groups. It is concluded that rinsing with povidone-iodine reduces the incidence, severity and duration of oral mucositis during antineoplastic radiochemotherapy.

Topics: Adult; Aged; Aged, 80 and over; Anti-Infective Agents, Local; Antifungal Agents; Antineoplastic Combined Chemotherapy Protocols; Area Under Curve; Chemoprevention; Combined Modality Therapy; Female; Follow-Up Studies; Head and Neck Neoplasms; Humans; Immunization, Passive; Incidence; Iodophors; Male; Middle Aged; Mouthwashes; Nystatin; Pantothenic Acid; Povidone-Iodine; Radiotherapy; Rutin; Stomatitis; Time Factors; Vasodilator Agents

Topics: Anti-Infective Agents, Local; Betacoronavirus; Coronavirus Infections; COVID-19; Cross Infection; Head and Neck Neoplasms; Humans; Medical Oncology; Pandemics; Personal Protective Equipment; Pneumonia, Viral; Povidone-Iodine; Public Health; SARS-CoV-2; Skull Base

Povidone-iodine is known for successfully treating surgical wounds; the combination between povidone-iodine and sugar, also called Knutson's formula, has been proposed to improve wound healing. Currently, no studies have investigated the effects of Knutson's formula to treat defects in wound closure following radio-chemotherapy in the head and neck region. The aim of this study is to evaluate the efficacy of Knutson's formula in improving the wound-healing process in patients who underwent radio-chemotherapy after surgery for head and neck cancer. The study, conducted from August 2013 to January 2017, included a sample of 34 patients (25 males and 9 females; age range: 60-75 years) treated with radio-chemotherapy after head and neck cancer surgery. All patients suffered from defect of wound regeneration. Patients were randomly divided into two groups: patients in the study group (n = 18) were treated with Knutson's formula; patients in the control group (n = 16) were treated with traditional topical drugs. In the study group, 16 of 18 (88.9%) patients reached complete wound closure 1 month after treatment, with no wound infections. In the control group, only three patients (18.7%) showed complete wound closure within a month; in addition, one patient required systemic antibiotic treatment because of supra-bacterial infection of the wound. In our sample, the combination of povidone-iodine and sugar had a higher success rate compared with traditional topical treatment in the treatment of wound defect closure in oncological patients who underwent radio-chemotherapy.

Topics: Administration, Topical; Aged; Anti-Infective Agents, Local; Antineoplastic Agents; Female; Glucose Solution, Hypertonic; Head and Neck Neoplasms; Humans; Male; Middle Aged; Povidone-Iodine; Radiotherapy; Surgical Wound Dehiscence; Surgical Wound Infection; Wound Healing

It is common practice to irrigate the operative site following tumor resection during major head and neck surgery. A variety of irrigation solutions are used, but there are few data on their relative efficacies in this context.. The effect of different irrigation solutions on cell survival was assessed by clonogenic survival assay in 5 head and neck squamous cell carcinoma cell lines at different time points.. Saline had no effect on cell survival in any of the cell lines tested. Hydrogen peroxide, povidone-iodine, and a hydrogen peroxide/povidone-iodine mix caused complete cell death in all cell lines. Irrigation with distilled water caused a significant reduction in cell survival in 3 cell lines. Duration of exposure showed no effect on cell survival.. These data suggest a significant difference in the cytocidal effect of commonly used irrigation solutions on head and neck cancer cells in an in vitro model.

Topics: Anti-Infective Agents, Local; Carcinoma, Squamous Cell; Cell Culture Techniques; Cell Line, Tumor; Cell Survival; Head and Neck Neoplasms; Humans; Hydrogen Peroxide; Pharmaceutical Solutions; Povidone-Iodine; Sodium Chloride; Squamous Cell Carcinoma of Head and Neck; Therapeutic Irrigation; Water

Topics: Aged; Anti-Infective Agents, Local; Carcinoma, Squamous Cell; Head and Neck Neoplasms; Humans; Lymph Nodes; Lymphatic Metastasis; Male; Myiasis; Neck; Necrosis; Povidone-Iodine; Therapeutic Irrigation; Ulcer

Free cancer cells can be spilled out from exposed tumors or ruptured tumors. We examined the cytocidal effect of various irrigation fluids on free cancer cells in an animal wound model mimicking head and neck surgery.. Cancer cell-contaminated wounds were made with C3H/HeJ mice and syngeneic squamous cell carcinoma (SCC VII) cells. Distilled water, 5% povidone-iodine, 1.5% H(2)O(2), normal saline, and cisplatin were used to irrigate for 5 minutes. In vitro tumor growth assays were done with different concentrations and exposure times of povidone-iodine and distilled water.. In the animal study, povidone-iodine significantly inhibited tumor growth. Povidone-iodine caused substantial inhibition of in vitro tumor growth, even at the concentration of 0.05%. After 30 seconds of exposure to 1% povidone-iodine, cancer cells were completely inhibited.. Povidone-iodine could be selected preferentially for the irrigation fluid during head and neck surgery, especially when the wound is suspected of cancer cell contamination.

Topics: Animals; Anti-Infective Agents, Local; Cell Proliferation; Disease Models, Animal; Female; Head and Neck Neoplasms; Hydrogen Peroxide; Intraoperative Complications; Mice; Mice, Inbred C3H; Neoplasm Seeding; Povidone-Iodine; Random Allocation; Sensitivity and Specificity; Therapeutic Irrigation; Tumor Cells, Cultured

Infection after head and neck oncological surgery is relatively frequent, and is associated with significant morbidity and mortality.. The primary objective of this prospective study was to determine risk factors for Surgical Site Infection (SSI) in major head and neck cancer surgery.. A population of 137 head and neck cancer patients, of the Portuguese Institute of Oncology Francisco Gentil (Lisbon, Portugal), was prospectively studied in order to ascertain the correlation between 31 known risk factors and the presence of SSI.. The rate of SSI was 10.9%, with all of the infections being of the deep incisional type. A discriminant analysis and multiple logistic regression methods identified pre-surgical tracheostomy (p < 0.001), previous surgery (p = 0.001) and length of pre-operative hospital stay (p < 0.001) as the most significant risk factors for surgical site infections.. In order to minimize the risk of post-operative SSI in the context of head and neck cancer patients, particular attention should be paid to patients submitted to tracheostomy before surgery, to those submitted to previous oncological surgery, and to patients who are forced to remain in the hospital for prolonged periods of time before surgery.

Topics: Adult; Aged; Aged, 80 and over; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anti-Infective Agents, Local; Antibiotic Prophylaxis; Debridement; Disinfection; Drainage; Female; Forecasting; Head and Neck Neoplasms; Humans; Length of Stay; Male; Middle Aged; Neoadjuvant Therapy; Povidone-Iodine; Preoperative Care; Prospective Studies; Reoperation; Risk Factors; Staphylococcal Infections; Surgical Wound Infection; Tracheostomy

For post-Mohs surgical defects of the head and neck, the width of the defect is the best predictor of the length of that time it will take the wound to heal. This conclusion is based on a multivariate analysis, testing the effect of the following factors on wound-healing time: (1) age, (2) sex, (3) sound location, (4) wound width, (5) wound length, and (6) wound length X wound width. After accounting for wound width, none of the other factors significantly influenced the rate of wound healing. The 64 wounds evaluated were dressed daily with one of five bandages. When compared with the controls, and after correcting for wound width, each of the test bandages shortened wound-healing time. Among the treatment groups, no significant differences were found in the cultures or in the appearance of the wounds.

Topics: Aged; Bacitracin; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Drug Combinations; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Occlusive Dressings; Polymyxin B; Postoperative Period; Povidone-Iodine; Statistics as Topic; Time Factors; Wound Healing

Topics: Head and Neck Neoplasms; Humans; Povidone; Povidone-Iodine; Surgical Wound Infection