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Boswellia serrata acts on cerebral edema in patients irradiated for brain tumors
A prospective, randomized, placebo-controlled, double-blind pilot trial
Article first published online: 1 FEB 2011
Copyright © 2011 American Cancer Society
Volume 117, Issue 16, pages 3788–3795, 15 August 2011
How to Cite
Kirste, S., Treier, M., Wehrle, S. J., Becker, G., Abdel-Tawab, M., Gerbeth, K., Hug, M. J., Lubrich, B., Grosu, A.-L. and Momm, F. (2011), Boswellia serrata acts on cerebral edema in patients irradiated for brain tumors. Cancer, 117: 3788–3795. doi: 10.1002/cncr.25945
- Issue published online: 3 AUG 2011
- Article first published online: 1 FEB 2011
- Manuscript Accepted: 28 DEC 2010
- Manuscript Revised: 19 DEC 2010
- Manuscript Received: 27 AUG 2010
- brain edema;
- brain tumor;
- Boswellia serrata;
- supportive care
Patients irradiated for brain tumors often suffer from cerebral edema and are usually treated with dexamethasone, which has various side effects. To investigate the activity of Boswelliaserrata (BS) in radiotherapy-related edema, we conducted a prospective, randomized, placebo-controlled, double-blind, pilot trial.
Forty-four patients with primary or secondary malignant cerebral tumors were randomly assigned to radiotherapy plus either BS 4200 mg/day or placebo. The volume of cerebral edema in the T2-weighted magnetic resonance imaging (MRI) sequence was analyzed as a primary endpoint. Secondary endpoints were toxicity, cognitive function, quality of life, and the need for antiedematous (dexamethasone) medication. Blood samples were taken to analyze the serum concentration of boswellic acids (AKBA and KBA).
Compared with baseline and if measured immediately after the end of radiotherapy and BS/placebo treatment, a reduction of cerebral edema of >75% was found in 60% of patients receiving BS and in 26% of patients receiving placebo (P = .023). These findings may be based on an additional antitumor effect. There were no severe adverse events in either group. In the BS group, 6 patients reported minor gastrointestinal discomfort. BS did not have a significant impact on quality of life or cognitive function. The dexamethasone dose during radiotherapy in both groups was not statistically different. Boswellic acids could be detected in patients' serum.
BS significantly reduced cerebral edema measured by MRI in the study population. BS could potentially be steroid-sparing for patients receiving brain irradiation. Our findings will need to be further validated in larger studies. Cancer 2011. © 2011 American Cancer Society.