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Welche Indikationen gibt es für die Einnahme von Selen?

 Outcome name
Asfour et al. (2006): Effect of high-dose sodium selenite therapy on polymorphonuclear leukocyte apoptosis in non-Hodgkin's lymphoma patientsToxicity
Ejection fraction
Büntzel et al. (2010): Limited effects of selenium in the prevention of radiation-associated toxicities - results of a randomized study in head neck cancer patientsToxicity
Büntzel et al. (2010): Selenium Substitution During Radiotherapy of Solid Tumours - Laboratory Data from Two Observation Studies in Gynaecological and Head and Neck Cancer PatientsSelenium level
Goossens et al. (2016): Phase III randomised chemoprevention study with selenium on the recurrence of non-invasive urothelial carcinoma. The SELEnium and BLAdder cancer TrialRFS (Recurrence-Free Survival)
PFS (Progression-Free Survival)
Selenium level
Jahangard-Rafsanjani et al. (2013): The efficacy of selenium in prevention of oral mucositis in patients undergoing hematopoietic SCT: a randomized clinical trialHaematological indices
Length of hospital stay
Incidence of acute GVHD (Graft-Versus-Host Disease)
Mortality rate
Non-haematological indices
Selenium level
Mucositis
Fever
Karp et al. (2012): Randomized, double-blind, placebo-controlled, phase III chemoprevention trial of selenium supplementation in patients with resected stage I non-small-cell lung cancer: ECOG 5597OS (Overall Survival)
Toxicity
Selenium level
DFS (Disease-Free Survival)
Laali et al. (2020): Effect of Selenium on Incidence and Severity of Mucositis during Radiotherapy in Patients with Head and Neck CancerSelenium level
Mucositis
Mix et al. (2015): Randomized phase II trial of selenomethionine as a modulator of efficacy and toxicity of chemoradiation in squamous cell carcinoma of the head and neckMucositis
Tumor response
PFS (Progression-Free Survival)
OS (Overall Survival)
Quality of life
Toxicity
Muecke et al. (2010): Multicenter, phase 3 trial comparing selenium supplementation with observation in gynecologic radiation oncologySelenium level
Toxicity
Performance Status
Quality of life
DFS (Disease-Free Survival)
OS (Overall Survival)
Muecke et al. (2013): Impact of treatment planning target volumen (PTV) size on radiation induced diarrhoea following selenium supplementation in gynecologic radiation oncology-a subgroup analysis of a multicenter, phase III trialToxicity
Muecke et al. (2014): Multicenter, phase 3 trial comparing selenium supplementation with observation in gynecologic radiation oncology: follow-up analysis of the survival data 6 years after cessation of randomizationDFS (Disease-Free Survival)
OS (Overall Survival)
Stratton et al. (2010): Oral Selenium Supplementation Has No Effect on Prostate- Specific Antigen Velocity in Men Undergoing Active Surveillance for Localized Prostate CancerPSA level (Prostate-Specific Antigen)


Hilft Vitamin C gegen Fatigue?

 Results after intervention
Jeon et al. (2016): Effect of intravenous high dose Vitamin C on postoperative pain and morphine use after laparoscopic colectomy: A randomized controlled trialEstimated mean (SD) from graphic:

2, 6 and 24h post-op: at rest significantly lower in intervention compared to placebo; p's<0.05 (no values reported, only graphs)

While coughing: no significant difference at any time point; p's>0.05
Morphine use (in mg) at 2h was significantly lower in intervention arm (p<0.05), no significant difference between the two arms at 6h and 24h (p's>0.05).
No difference between groups in postoperative fatigue scores (p's>0.05)
Rescue analgesics were required more frequently in the placebo arm; significant difference compared to intervention arm (p = 0.00).

Frequency as Mean(SD): Intervention: 0.8(0.8)

Placebo: 1.4(1.0)

Welche Evidenz gibt es für Vitamin C hochdosiert?

Welche Nebenwirkungen hat Curcumin?

 Side Effects / Interactions
Hejazi et al. (2013): A pilot clinical trial of radioprotective effects of curcumin supplementation in patients with prostate cancerAccording to information no side effects
According to information no side effect
Hejazi et al. (2016): Effect of Curcumin Supplementation During Radiotherapy on Oxidative Status of Patients with Prostate Cancer: A Double Blinded, Randomized, Placebo-Controlled StudyAccording to information no side effects
According to information no side effect
Mansourian et al. (2015): The effect of "curcuma Longa" topical gel on radiation -induced oral mucositis in patients with head and neck cancerNI
NI
Rao et al. (2014): The Indian Spice Turmeric Delays and Mitigates Radiation-Induced Oral Mucositis in Patients Undergoing Treatment for Head and Neck Cancer: An Investigational StudyNI
NI
Ryan et al. (2013): Curcumin for radiation dermatitis: a randomized, double-blind, placebo-controlled clinical trial of thirty breast cancer patientsAccording to information no side effects.
According to information no side effects.

Hilft Curcumin gegen Übelkeit?

Outcome Übelkeit kommt bei Topic Curcumin nicht vor.

Verbessert Vitamin D die Osteoporose?

In welcher Dosis sollte Vitamin D eingenommen werden?

 Dosage and regime
Akiba et al. (2018): Vitamin D Supplementation and Survival of Patients with Non–small Cell Lung Cancer: A Randomized, Double-Blind, Placebo-Controlled TrialTwo capsules of vitamin D3 (total 1,200 IU/day), for 12 months
Two capsule form and identical in appearance and taste, containing sesame oil, gelatin derived from swine, and glycerin, for 12 months
Antunac et al. (2018): Vitamin D Supplementation and Survival in Metastatic Colorectal CancerCholecalciferol 2000 IU daily, for 2 years or until death, whichever came first
Only standard chemotherapy
Attia et al. (2008): Randomized, Double-Blinded Phase II Evaluation of Docetaxel with or without Doxercalciferol in Patients with Metastatic, Androgen-Independent Prostate CancerSupplied by Genzyme as 2.5 μg soft gel capsules,10 μg (i.e., four capsules of 2.5 μg) of doxercalciferol orally each day of the chemotherapy cycles before breakfast and at the same time,

Duration: for 1-12 cycles of chemotherapy (each cycle: 28 days), median duration: 6 cycles
10 μg of placebo (equal in weight to, and containing only the inactive ingredients found in, the doxercalciferol capsules), orally each day of the chemotherapy cycles before breakfast and at the same time,

Duration: for 1-12 cycles of chemotherapy (each cycle: 28 days), median duration: 6 cycles
... further results

Für/gegen was ist die Einnahme von Aloe empfehlenswert?

 Outcome name
Heggie et al. (2002): A phase III study on the efficacy of topical aloe vera gel on irradiated breast tissueToxicity
Toxicity
Toxicity
Toxicity
Hoopfer et al. (2015): Three-arm randomized phase III trial: Quality aloe and placebo cream versus powder as skin treatment during breast cancer radiation therapyToxicity
Toxicity
Toxicity
Lissoni et al. (1998): Biotherapy with the Pineal Immunomodulating Hormone Melatonin versus Melatonin plus Aloe vera in Untreatable Advanced Solid NeoplasmsTumor response
Lissoni et al. (2009): A Randomized Study of Chemotherapy versus Biochemotherapy with Chemotherapy plus Aloe arborescens in Patients with Metastatic CancerTumor response
Toxicity
Mansouri et al. (2016): The Effect of Aloe Vera Solution on Chemotherapy-Induced Stomatitis in Clients with Lymphoma and Leukemia: A Randomized Controlled Clinical TrialStomatitis
Pain
Marucci et al. (2017): Double-blind randomized phase III study comparing a mixture of natural agents versus placebo in the prevention of acute mucositis during chemoradiotherapy for head and neck cancerToxicity
Pain
Olsen et al. (2001): The effect of aloe vera gel/mild soap versus mild soap alone in preventing skin reactions in patients undergoing radiation therapyToxicity
Puataweepong et. al (2009): The efficacy of oral Aloe vera juice for radiation induced mucositis in head and neck cancer patients: a double-blind placebo-controlled studyMucositis
Mucositis
Mucositis
Sahebjamee et al. (2015): Comparative Efficacy of Aloe vera and Benzydamine Mouthwashes on Radiation-induced Oral Mucositis: A Triple-blind, Randomised, Controlled Clinical TrialMucositis
Sahebnasagh et al. (2017): Successful Treatment of Acute Radiation Proctitis with Aloe Vera: A Preliminary Randomized Controlled Clinical TrialToxicity
Mental status/ function
Quality of life
Toxicity
Su et al. (2004): Phase II double-blind randomized study comparing oral aloe vera versus placebo to prevent radiation-related mucositis in patients with head-and-neck neoplasmsMucositis
Mucositis
Mucositis
Quality of life
Williams et al. (1996): Phase III double-blind evaluation of an aloe vera gel as a prophylactic agent for radiation-induced skin toxicity

Hilft Aloe bei Mukositis?

 Results after interventionOverall RoB judgment
Jahangard-Rafsanjani et al. (2013): The efficacy of selenium in prevention of oral mucositis in patients undergoing hematopoietic SCT: a randomized clinical trialNA
No difference between selenium arm (26.92±6.26 days) and placebo arm (25.81±4.33 days); p=0.38
Overall: No difference between the arms; p= 0.35
No difference between the arms; p= 0.69
Overall: No difference between arms for increase in serum creatinine; p=0.31 or increase in aspartate aminotransferase and alanine transaminase: p=0.62
Significant difference in mean serum selenium level between two arms at 14 days after transplantation (8.34 mcg/dL in the selenium arm vs 7.36 mcg/dL in the placebo arm), p=0.018
Overall: Cumulative incidence (grade 1-4) comparable in both selenium arm (83.8%) and placebo arm (81.1%); p=0.76; grade 3-4 mucositis significantly lower in selenium arm (10.8%) compared to placebo arm (35.1%); p=0.013 (grade 4: 2x in placebo arm, 0x in selenium arm)


Mean duration comparable (p=0.048), only duration of objective mucositis from grade 2 to 4 and back was significantly shorter in the selenium arm (3.6±1.84 days) than in the placebo arm (5.3±2.2 days); p=0.014
NA
some concerns
some concerns
some concerns
some concerns
some concerns
some concerns
high risk
some concerns
Laali et al. (2020): Effect of Selenium on Incidence and Severity of Mucositis during Radiotherapy in Patients with Head and Neck CancerAt the end of radiation (after 7 weeks) there was no difference in the mean serum selenium level between the selenium arm and placebo arm (p=0.24)

Based on the selenium level before radiation, developing severe oral mucositis was statistically significant postponed in patients who had selenium levels ≥ 65 mcg/L (p=0.04)
After 7 weeks no significant differences between the selenium arm and the placebo arm for:

  • mean duration of oral mucositis (grade 1–4) (p=0.27)
  • onset of oral mucosits (p =0.31)
  • recovery (day after radiation completion (p=0.80)
  • cumulative incidence of oral mucusitis (grade 1–4) (p=0.79)


Severe oral mucositis (grade 3 or 4) was seen in 25 patients in the selenium arm and in 20 patients in the placebo arm.


Addition: Development of oral mucositis in patients with selenium levels >65 mcg/l significantly delayed from baseline (p=0.04, no further explanation given)
NA
high risk
Mix et al. (2015): Randomized phase II trial of selenomethionine as a modulator of efficacy and toxicity of chemoradiation in squamous cell carcinoma of the head and neckOverall: No significant differences between arms (grade 3 intervention arm 2x, placebo arm 3x, no grade 4)
Only one patient from the intervention arm did not reach CR and died
After 12 months: No significant differences between arms
After 12 months: No significant differences between arms
No significant difference for week 6-8 post-treatment and Follow-up within a year
Overall:
  • Hearing dysfunction n=1 each in the intervention arm and placebo arm;
  • elevated creatinine n=1 in the placebo arm;
  • myelosuppression: anemia in the placebo arm n=1;
  • leukopenia in the intervention arm n=3 and placebo arm n=2;
  • dermatitis in the intervention arm n=2;
  • dry mouth in the placebo arm n=2;
  • dysgeusia in the intervention arm n=2, placebo arm n=1;
  • odyno-/dysphagia in the intervention arm n=1, placebo arm n=2;
  • oral/throat pain in the placebo arm n=2;
  • mucus/sputum intervention arm n=3, placebo arm n=1
some concerns
low risk
low risk
low risk
some concerns
some concerns

Schützt Aloe vor Hautentzündungen?

In welcher Dosis sollte man Ingwer bei Übelkeit einsetzen?

 Outcome nameDosage and regime
Ansari et al. (2016): Efficacy of Ginger in Control of Chemotherapy Induced Nausea and Vomiting in Breast Cancer Patients Receiving Doxorubicin- Based ChemotherapyNausea
Vomiting
Daily dose 2x2 ginger capsules (250mg ginger powder each), every 12h for 3 days over 3 cycles, start not specified
Daily dose 2x2 capsules, every 12h for 3 days over 3 cycles, start not specified
Fahimi et al. (2011): Evaluating the Effect of Zingiber Officinalis on Nausea and Vomiting in Patients Receiving Cisplatin Based RegimensNausea
Vomiting
Four capsules of powdered ginger (Zintoma®, Gol Daru) daily (each capsule contained 250 mg of ginger)
Four capsules of placebo (lactose)
Lua et al. (2015): Effects of inhaled ginger aromatherapy on chemotherapy-induced nausea and vomiting and health-related quality of life in women with breast cancerNausea
Quality of life
Unspecified effects
Antiemetics + bottle with 2 drops of ginger oil

Glass pendant (in the form of a small flask), to be hung approx. 20 cm from the nose, the bottle was held directly under the nose and inhaled deeply at least 3 times a day for 2 minutes each time

Start: Day 1 of chemotherapy
Worn for 5 days at a time from the day of the chemotherapy, inhaled deeply at least 3 times a day for 3 periods of 2 minutes each

Start: Day 1 of chemotherapy
Panahi et al. (2012): Effect of Ginger on Acute and Delayed Chemotherapy-Induced Nausea and Vomiting: A Pilot, Randomized, Open-Label Clinical TrialNausea and Vomiting
Nausea and Vomiting
Nausea and Vomiting
Daily dose 3x0.5g Every 8h, starting 30min after chemotherapy
Every 8h, starting 30min after Chemotherapy
Ryan et al. (2011): Ginger (Zingiber officinale) reduces acute chemotherapy-induced nausea: a URCC CCOP study of 576 patientsNausea
Nausea
Quality of life
Vomiting
250mg 2x3 ginger capsules (liquid extract from ginger root in virgin olive oil + excipients, 1.5g ginger daily)

1.5g daily
2x1 placebo capsules 250mg 2x2 ginger capsules ((liquid extract from ginger root in virgin olive oil + excipients and placebo capsules, 1.0g ginger daily)
2x2 placebo capsules

250mg 2x1 ginger capsules (liquid extract from ginger root in virgin olive oil + excipients and placebo capsules, 0.5g ginger daily)
2x3 placebo capsules
Sontakke et al. (2003): Ginger as an antiemetic in nausea and vomiting induced by chemotherapy: A randomized, cross-over, double blind studyNausea
Vomiting
Vomiting
Toxicity
Two capsules, each containing 500 mg of gin- ger powder, orally, 2 ml of normal saline IV, 20 min prior to chemotherapy. Two capsules of ginger were repeated after 6 h of cancer chemotherapy.
2 capsules of lactulose orally and injection metoclopramide 20 mg IV, 20 min prior to chemotherapy. Two capsules of 5 mg metoclopramide each, orally after 6 h
2 capsules of lactulose orally and injection ondansetron 4 mg IV, 20 min prior to chemotherapy and two capsules of ondansetron, 2 mg each, orally after 6 h.
Uthaipaisanwong et al. (2020): Effects of ginger adjunct to the standard prophylaxis on reducing carboplatin and paclitaxel-induced nausea vomiting: a randomized controlled studyNausea
Nausea
Vomiting
Toxicity
Daily dose 4x500mg before meals and one in the evening from day 1 to day 5 of chemotherapy

+ standard antiemetic medication included 20 mg of dexamethasone, 8 mg of ondansetron, and 50 mg of ranitidine which were injected 30 min before chemotherapy administration; if necessary 50mg dimenhydrinate before chemotherapy and 5 days at home
Daily dose before meals and one in the evening from day 1 to day 5 of chemotherapy

+ standard antiemetic medication included 20 mg of dexamethasone, 8 mg of ondansetron, and 50 mg of ranitidine which were injected 30 min before chemotherapy administration; if necessary 50mg dimenhydrinate before chemotherapy and 5 days at home
Zick et al. (2008): Phase II trial of encapsulated ginger as a treatment for chemotherapy-induced nausea and vomitingUnspecified effects
Nausea and Vomiting
Nausea and Vomiting
Toxicity
8 capsules daily
1.0-g ginger dose,

- Each capsule contained 250 mg dry extract of ginger root [10:1 (v/v) extraction solvent (ethanol 50%)/root] standard- ized to 15 mg (5%) of total gingerols - four capsules ginger and four capsules placebo daily
2.0-g ginger dose - Each capsule contained 250 mg dry extract of ginger root [10:1 (v/v) extraction solvent (ethanol 50%)/root] standardized to 15 mg (5%) of total gingerols

- 8 capsuels daily