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Efficacy of Aloe Vera Gel Topical Application on Radiation Induced Mucositis in Head and Neck Malignancy
INTRODUCTION: One word that is even more daunting than the death itself and eats up a person from the inside is cancer. Head and neck malignancy (HNM) is a heterogeneous disease characterized by complex clinical and pathologic presentations. The treatment of HNM has undergone a gradual evolution over the past 3 decades, with an increased emphasis placed on organ preservation and multimodality management, including the use of radiotherapy (RT) and chemotherapy. RT approach, however, is associated with increasing rates of muco-toxicity that have been well documented in the context of numerous clinical trials in light of the radiation oncology literature and Cochrane reviews containing no consensus or universal standard of care for the prevention or treatment of radiation-induced-mucositis (RIM) that occurs inevitably in all patients undergoing RT. The current management focuses more on palliative measures, such as pain management, nutritional support, and maintenance of good oral hygiene. NEED AND SIGNIFICANCE: Studies have suggested that Aloe-vera can enhance wound healing by reducing vasoconstriction and platelet aggregation at the wound site, improving wound oxygenation, scavenging free radicals, increasing collagen formation, inhibiting collagenase and metalloproteinase, and activating macrophages. (1-4) Furthermore, it has antioxidant properties and eliminates production of free radicals. Studies to-date has had different dimensions and only two clinical-studies have been undertaken so far as specified in review of literature. In one study, the researcher used aloe-vera as a mouth wash where its effect got limited over a few minutes and in the other research, the researcher used it in oral form where it acted as a systemic agent than a local agent. Considering these factors and the uncertainties about the use of aloe-vera for the prevention of RIM, the researcher decided to examine the issue in a self-controlled clinical trial using local application gel of aloe-vera versus its base gel. PROBLEM STATEMENT: “A randomized double blind clinical trial to assess the effectiveness of topical application of Aloe-Vera gel versus base-gel on radiation-induced mucositis in patients receiving radiation therapy for Head and Neck Malignancy in a selected hospital in Mumbai, India” ...