Discussion
tumor, death, milder burning mouth sensation, breast cancer, pain, mucositis, dermatitis
TUMOR, BREAST CANCER, NEOPLASMS, MUCOSITIS, DERMATITIS
In the current single-blind, randomized clinical trial, patients treated with either the oral or topical curcumin showed a significantly reduced severity and burning related to OM during the first 3 weeks after administration as compared with the placebo group. However, no difference was observed between oral and topical curcumin groups.Determination of the appropriate radiation sensitivity is determinantal in increasing the chance of tumor cell death and minimizing the radiation damage to normal tissues [In 2016, Elad et al. reported that curcumin mouthwash is safe and tolerable for the prevention of mucositis in children [In a single-blind, randomized trial, Rao et al. treated the RT-receiving patients with iodine/pharyngeal neoplasms, or povidone-iodine and curcumin. Although the incidence of total mucositis did not differ between groups, the curcumin group experienced less intolerable mucositis as well as decreased mucosal severity. It should be considered that povidone-iodine is uncommonly used for ROM. Similar common agents such as lidocaine and chlorhexidine have no effect because they are designed for symptomatic treatment while curcumin is focused on reducing molecular inflammatory factors [Almost all of the studies evaluating the anti-inflammatory effect of curcumin showed satisfactory outcomes. Mansourian et al. compared the effect of curcuma longa or placebo topical gel for 8 weeks on ROM. They revealed that patients who received curcuma longa experienced lower OM grades and milder burning mouth sensation. In our study patients in curcumin groups reported feeling more comfort in their mouth [In a clinical trial study, Rayan et al. reported that oral curcumin reduced the severity of dermatitis in breast cancer patients compared with the placebo group (P-Value = 0.008) during radiation therapy [The results of three recent systematic reviews suggested curcumin is safe, remarkably well tolerated, and effective in preventing and ameliorating of mucositis lesions. As the number of the included studies were few, all of them recommended that further well-designed investigations is required to confirm the promising effects of curcumin in mucositis lesions [Up to now, many studies have been conducted to reveal the protective effects of curcumin against pain and burning [This study, however, had several limitations. Although 106 patients were screened for eligibility criteria, only a limited number of them were eligible and completed the study due to the COVID-19 pandemic. Further studies with a larger sample size are recommended to establish the role of topical or oral curcumin in ROM management. Other confounding factors included radiation site and dose, which could affect the severity of OM. Future studies should address the potential effect of oral or topical curcumin in a dose-finding study.