Role of curcumin as an adjuvant in treatment of advanced head and neck squamous cell carcinoma
Keywords:Head and neck squamous cell carcinoma, Radiation, Chemo radiation, Radiosensitiser, Curcumin
Background: Chemoradiation forms the major line of treatment in advanced head and neck squamous cell carcinoma, but the benefit of chemotherapeutic agents is at the expense of various toxicities. Curcumin has demonstrated promising results in in-vivo and in-vitro studies as a radiosensitiser. The objective of the study was to determine the role of curcumin as an adjuvant in patients undergoing chemo radiation for advanced head and neck cancers.
Methods: Study involved 21 patients who underwent chemo radiotherapy for advanced head and neck cancers. They were randomized into two groups. Group A received 500 mg of curcumin while, Group B received placebo along with chemoradiation. The response was assessed using RECIST criteria at three months post treatment using contrast enhanced computerized tomography scan.
Results: Overall 58.3% patients had partial response and 41.7% patients had stable disease in group A. In group B, 33.3% patients had a partial response and 66.6% patient had a stable disease.
Conclusions: Patients receiving curcumin along with chemoradiation had a marginal decrease in tumour volume and 58.3% patients had partial response and 41.7% had stable disease. A statistical significance could not be achieved due to lack of stage-match controls. Further studies are required to validate the role of curcumin as an adjuvant in the treatment of head and neck squamous cell carcinomas.
Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC Cancer Base No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available at: http://globocan.iarc.fr. Accessed on 14 January 2014.
Hennequin C, Favaudon V. Biological basis for chemo-radiotherapy interactions. Eur J Cancer. 2002;38:223-30.
Gupta T, Agarwal JP, Ghosh-Laskar S, Parikh PM, D'Cruz AK, Dinshaw KA. Radical radiotherapy with concurrent weekly cisplatin in loco-regionally advanced squamous cell carcinoma of the head and neck: a single-institution experience. Head Neck Oncol. 2009;1:17.
Wilken R, Veena MS, Wang MB, Srivatsan ES. Curcumin: A review of anti¬cancer properties and therapeutic activity in head and neck squamous cell carcinoma. Mol Cancer. 2011;10:12.
Aggarwal BB, Surh YJ, Shishodia S. The Molecular Targets and Therapeutic Uses of Curcumin in Health and Disease. Adv Experimental Med Biol. 2007;595:159-161.
Sa G, Das T. Anti cancer effects of curcumin: cycle of life and death. Cell Div. 2008;3:14.
Ikezaki S, Nishikawa A, Furukawa F, Kudo K, Nakamura H, Tamura K, et al. Chemopreventive effects of curcumin on glandular stomach carcinogenesis induced by N-methyl-N-nitro-N-nitrosoguanidine and sodium chloride in rats. Anticancer Res. 2001;21(5):3407-11.
Singletary K, MacDonald C, Iovinelli M, Fisher C, Wallig M. Effect of the betadiketones diferuloylmethane (curcumin) and dibenzoyl-methane on rat mammary DNA adducts and tumors induced by 7,12- dimethylbenz[a] anthracene. Carcinogenesis. 1998;19(6):1039-43.
Khafif A, Lev-Ari S, Vexler A, Barnea I, Starr A, Karaush V, et al. Curcumin: a potential radio-enhancer in head and neck cancer. Laryngoscope 2009;119(10):2019-26.
Meerten EL, Gelderblom H, Bloem JL. RECIST revised: implications for the radiologist. A review article on the modified RECIST guideline. Eur Radiol. 2010;20:1456–67.
Geiger JL, Lazim AF, Walsh FJ, Foote RL, Moore EJ, Okuno SH. et al. Adjuvant chemoradiation therapy with high-dose versus weekly cisplatin for resected, locally-advanced HPV/p16-positive and negative head and neck squamous cell carcinoma. Oral Oncol. 2014;50(4):311-8.
Lev-Ari S, Zinger H, Kazanov D, Yona D, Ben-Yosef R, Starr A, et al. Curcumin synergistically potentiates the growth inhibitory and pro¬apoptotic effects of celecoxib. Biomed Pharmacother. 2005;59(Suppl 2):S276-80.
Jurenka JS. Anti-inflammatory properties of curcumin, a major constituent of Curcuma longa: a review of preclinical and clinical research.Altern Med Rev. 2009;14(2):141-53.
Bayet-Robert M, Kwiatkowski F, Leheurteur M, Gachon F, Planchat E, Abrial C, et al. Phase I dose escalation trial of docetaxel plus curcumin in patients with advanced and metastatic breast cancer. Cancer Biol Ther. 2010;9(1):8-14.