Nutritional Supportive Care in Head and Neck Cancer Patients – A Narrative Review

Radhika, Doppalapudi; Muthukrishnan, Arvind; Issrani, Rakhi

doi:10.61186/ijbc.16.4.105

Volume 16, Issue 4 (December 2024 2024) Iranian Journal of Blood and Cancer 2024, 16(4): 105-113 | Back to browse issues page

‎ 10.61186/ijbc.16.4.105

Mendeley

Zotero

RefWorks

Radhika D, Muthukrishnan A, Issrani R. Nutritional Supportive Care in Head and Neck Cancer Patients – A Narrative Review. Iranian Journal of Blood and Cancer 2024; 16 (4) :105-113
URL: http://ijbc.ir/article-1-1650-en.html

Nutritional Supportive Care in Head and Neck Cancer Patients – A Narrative Review

Doppalapudi Radhika¹

, Arvind Muthukrishnan¹

, Rakhi Issrani ^*²

1- Department of Oral Medicine and Radiology, Saveetha Dental college and hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamilnadu, India.
2- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia. & Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India. , dr.rakhi.issrani@jodent.org

Abstract: (404 Views)

Head and neck cancer patients are more at high risk for malnutrition before, during, and after the cancer treatment procedures due to the proximity of key anatomical structures that are essential for mastication and deglutition. A multidisciplinary approach beginning with preliminary nutritional screening, comprehensive assessment, and nutritional supportive care is mandatory for all head and neck cancer patients. Such interventions not only improve quality of life but also increase the survival rate of the head and neck cancer patients. This updated narrative review focused on the recent updates of the various steps involved in the nutritional management of head and neck cancer patients, like pre-treatment nutritional care, screening and assessment, and nutritional interventions during and after cancer therapy with updates on nanoformulations of nutraceuticals. We reviewed all published literature between 2014 and 2024 about nutrition in head and neck cancer patients from major databases such as Embase, Web of Science, and PubMed. In addition to the nutritional parameters that should be considered during the nutritional assessment of patients with head and neck cancer, this review underscores the therapeutic efficacy of nutraceuticals in treating this disease. This narrative review added a note on recent updates on the use of a combination of novel nanoformulated nutraceuticals with chemotherapeutic agents, which were known for the improved drug delivery, such as targeting the neoplastic cells and thus preventing adverse effects.

Keywords: Cancer, Immunonutrition, Malnutrition, Nutritional support, Nano formulations, Nutraceuticals

Full-Text [PDF 522 kb] (232 Downloads)

: Mini Review | Subject: Adults Hematology & Oncology
Received: 2024/11/5 | Accepted: 2024/12/4 | Published: 2024/12/30

References

1. Argiris A, Karamouzis MV, Raben D, Ferris RL. Head and neck cancer. Lancet. 2008;371(9625):1695-709. [DOI:10.1016/S0140-6736(08)60728-X]

2. Gormley M, Creaney G, Schache A, Ingarfield K, Conway DI. Reviewing the epidemiology of head and neck cancer: definitions, trends and risk factors. Br Dent J. 2022;233(9):780-6. [DOI:10.1038/s41415-022-5166-x]

3. Mesia R, Iglesias L, Lambea J, Martínez-Trufero J, Soria A, Taberna M, et al. SEOM clinical guidelines for the treatment of head and neck cancer (2020). Clin Transl Oncol. 2021;23(5):913-21. [DOI:10.1007/s12094-020-02533-1]

4. Casas Rodera P, de Luis DA, Gómez Candela C, Culebras JM. Immunoenhanced enteral nutrition formulas in head and neck cancer surgery: a systematic review. Nutr Hosp. 2012;27(3):681-90.

5. Ni J, Zhang L. Cancer Cachexia: Definition, Staging, and Emerging Treatments. Cancer Manag Res. 2020;12:5597-605. [DOI:10.2147/CMAR.S261585]

6. Nishikawa H, Goto M, Fukunishi S, Asai A, Nishiguchi S, Higuchi K. Cancer Cachexia: Its Mechanism and Clinical Significance. Int J Mol Sci. 2021;22(16). [DOI:10.3390/ijms22168491]

7. Mäkitie AA, Alabi RO, Orell H, Youssef O, Almangush A, Homma A, et al. Managing Cachexia in Head and Neck Cancer: a Systematic Scoping Review. Adv Ther. 2022;39(4):1502-23. [DOI:10.1007/s12325-022-02074-9]

8. Elia M. Defining, Recognizing, and Reporting Malnutrition. Int J Low Extrem Wounds. 2017;16(4):230-7. [DOI:10.1177/1534734617733902]

9. Castillo-Martínez L, Castro-Eguiluz D, Copca-Mendoza ET, Pérez-Camargo DA, Reyes-Torres CA, Ávila EA, et al. Nutritional Assessment Tools for the Identification of Malnutrition and Nutritional Risk Associated with Cancer Treatment. Rev Invest Clin. 2018;70(3):121-5. [DOI:10.24875/RIC.18002524]

10. Reber E, Schönenberger KA, Vasiloglou MF, Stanga Z. Nutritional Risk Screening in Cancer Patients: The First Step Toward Better Clinical Outcome. Front Nutr. 2021;8:603936. [DOI:10.3389/fnut.2021.603936]

11. Bianchini C, Ciorba A, Stomeo F, Pelucchi S, Pastore A. Immunonutrition in head and neck cancer: have a look before surgery! Eur Arch Otorhinolaryngol. 2012;269(1):5-8. [DOI:10.1007/s00405-011-1725-5]

12. Ackerman D, Laszlo M, Provisor A, Yu A. Nutrition Management for the Head and Neck Cancer Patient. Cancer Treat Res. 2018;174:187-208. [DOI:10.1007/978-3-319-65421-8_11]

13. Findlay M, Rankin NM, Shaw T, White K, Boyer M, Milross C, et al. Best Evidence to Best Practice: Implementing an Innovative Model of Nutrition Care for Patients with Head and Neck Cancer Improves Outcomes. Nutrients. 2020;12(5). [DOI:10.3390/nu12051465]

14. Sandmael JA, Sand K, Bye A, Solheim TS, Oldervoll L, Helvik AS. Nutritional experiences in head and neck cancer patients. Eur J Cancer Care (Engl). 2019;28(6):e13168. [DOI:10.1111/ecc.13168]

15. Kubrak C, Olson K, Jha N, Jensen L, McCargar L, Seikaly H, et al. Nutrition impact symptoms: key determinants of reduced dietary intake, weight loss, and reduced functional capacity of patients with head and neck cancer before treatment. Head Neck. 2010;32(3):290-300. [DOI:10.1002/hed.21174]

16. Talwar B, Donnelly R, Skelly R, Donaldson M. Nutritional management in head and neck cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol. 2016;130(S2):S32-s40. [DOI:10.1017/S0022215116000402]

17. Bossola M. Nutritional interventions in head and neck cancer patients undergoing chemoradiotherapy: a narrative review. Nutrients. 2015;7(1):265-76. [DOI:10.3390/nu7010265]

18. Brown TE, Banks MD, Hughes BGM, Lin CY, Kenny LM, Bauer JD. Comparison of Nutritional and Clinical Outcomes in Patients with Head and Neck Cancer Undergoing Chemoradiotherapy Utilizing Prophylactic versus Reactive Nutrition Support Approaches. J Acad Nutr Diet. 2018;118(4):627-36. [DOI:10.1016/j.jand.2016.10.013]

19. Silver HJ, Dietrich MS, Murphy BA. Changes in body mass, energy balance, physical function, and inflammatory state in patients with locally advanced head and neck cancer treated with concurrent chemoradiation after low-dose induction chemotherapy. Head Neck. 2007;29(10):893-900. [DOI:10.1002/hed.20607]

20. Cantwell LA, Fahy E, Walters ER, Patterson JM. Nutritional prehabilitation in head and neck cancer: a systematic review. Support Care Cancer. 2022;30(11):8831-43. [DOI:10.1007/s00520-022-07239-4]

21. Howes N, Atkinson C, Thomas S, Lewis SJ. Immunonutrition for patients undergoing surgery for head and neck cancer. Cochrane Database Syst Rev. 2018;8(8):Cd010954. [DOI:10.1002/14651858.CD010954.pub2]

22. Arends J. Struggling with nutrition in patients with advanced cancer: nutrition and nourishment-focusing on metabolism and supportive care. Ann Oncol. 2018;29(suppl_2):ii27-ii34. [DOI:10.1093/annonc/mdy093]

23. Nesemeier R, Dunlap N, McClave SA, Tennant P. Evidence-Based Support for Nutrition Therapy in Head and Neck Cancer. Curr Surg Rep. 2017;5(8):18. [DOI:10.1007/s40137-017-0179-0]

24. List MA, Knackstedt M, Liu L, Kasabali A, Mansour J, Pang J, et al. Enhanced recovery after surgery, current, and future considerations in head and neck cancer. Laryngoscope Investig Otolaryngol. 2023;8(5):1240-56. [DOI:10.1002/lio2.1126]

25. Frydrych AM, Parsons R, Kujan O. Use of oral nutritional supplements in irradiated patients with head and neck cancer. Oral Dis. 2024;30(7):4165-73. [DOI:10.1111/odi.14837]

26. Dai T, Xian J, Li X, Wang Z, Hu W. Effect of nutrition impact symptoms on oral nutritional supplements energy intake and use days in patients with head and neck cancer: A cross-sectional study. Cancer Med. 2024;13(10):e7288. [DOI:10.1002/cam4.7288]

27. Mueller SA, Mayer C, Bojaxhiu B, Aeberhard C, Schuetz P, Stanga Z, et al. Effect of preoperative immunonutrition on complications after salvage surgery in head and neck cancer. J Otolaryngol Head Neck Surg. 2019;48(1):25. [DOI:10.1186/s40463-019-0345-8]

28. Maschke J, Kruk U, Kastrati K, Kleeberg J, Buchholz D, Erickson N, et al. Nutritional care of cancer patients: a survey on patients' needs and medical care in reality. Int J Clin Oncol. 2017;22(1):200-6. [DOI:10.1007/s10147-016-1025-6]

29. Halilova KI, Pisu M, Azuero A, Williams CP, Kenzik KM, Williams GR, et al. Healthy lifestyle discussions between healthcare providers and older cancer survivors: Data from 12 cancer centers in the Southeastern United States. Cancer Med. 2019;8(16):7123-32. [DOI:10.1002/cam4.2568]

30. Keinki C, Seilacher E, Ebel M, Ruetters D, Kessler I, Stellamanns J, et al. Information Needs of Cancer Patients and Perception of Impact of the Disease, of Self-Efficacy, and Locus of Control. J Cancer Educ. 2016;31(3):610-6. [DOI:10.1007/s13187-015-0860-x]

31. van Veen MR, Beijer S, Adriaans AM, Vogel-Boezeman J, Kampman E. Development of a Website Providing Evidence-Based Information About Nutrition and Cancer: Fighting Fiction and Supporting Facts Online. JMIR Res Protoc. 2015;4(3):e110. [DOI:10.2196/resprot.4757]

32. Avancini A, Sartori G, Gkountakos A, Casali M, Trestini I, Tregnago D, et al. Physical Activity and Exercise in Lung Cancer Care: Will Promises Be Fulfilled? Oncologist. 2020;25(3):e555-e69. [DOI:10.1634/theoncologist.2019-0463]

33. Cormie P, Zopf EM, Zhang X, Schmitz KH. The Impact of Exercise on Cancer Mortality, Recurrence, and Treatment-Related Adverse Effects. Epidemiol Rev. 2017;39(1):71-92. [DOI:10.1093/epirev/mxx007]

34. Dean E, Skinner M, Myezwa H, Mkumbuzi V, Mostert K, Parra DC, et al. Health Competency Standards in Physical Therapist Practice. Phys Ther. 2019;99(9):1242-54. [DOI:10.1093/ptj/pzz087]

35. van Veen MR, Mols F, Smeets L, Kampman E, Beijer S. Colorectal cancer survivors' beliefs on nutrition and cancer; correlates with nutritional information provision. Support Care Cancer. 2020;28(3):1255-63. [DOI:10.1007/s00520-019-04934-7]

36. van Veen MR, Winkels RM, Janssen SHM, Kampman E, Beijer S. Nutritional Information Provision to Cancer Patients and Their Relatives Can Promote Dietary Behavior Changes Independent of Nutritional Information Needs. Nutr Cancer. 2018;70(3):483-9. [DOI:10.1080/01635581.2018.1446092]

37. Deftereos I, Yeung JMC, Arslan J, Carter VM, Isenring E, Kiss N, et al. Assessment of Nutritional Status and Nutrition Impact Symptoms in Patients Undergoing Resection for Upper Gastrointestinal Cancer: Results from the Multi-Centre NOURISH Point Prevalence Study. Nutrients. 2021;13(10). [DOI:10.3390/nu13103349]

38. Erickson N, Paradies K, Buchholz D, Huebner J. Nutrition care of cancer patients-A survey among physicians and nurses. Eur J Cancer Care (Engl). 2018;27(4):e12855. [DOI:10.1111/ecc.12855]

39. Philip EJ, Coups EJ, Feinstein MB, Park BJ, Wilson DJ, Ostroff JS. Physical activity preferences of early-stage lung cancer survivors. Support Care Cancer. 2014;22(2):495-502. [DOI:10.1007/s00520-013-2002-5]

40. AuYoung M, Linke SE, Pagoto S, Buman MP, Craft LL, Richardson CR, et al. Integrating Physical Activity in Primary Care Practice. Am J Med. 2016;129(10):1022-9. [DOI:10.1016/j.amjmed.2016.02.008]

41. Hübner J, Muenstedt K, Muecke R, Micke O, Stoll C, Kleeberg UR, et al. Counseling cancer patients on complementary and alternative medicine. Background, theory, and implementation of nationwide counseling facilities. Strahlenther Onkol. 2013;189(8):613-7. [DOI:10.1007/s00066-013-0392-4]

42. Waterland JL, Edbrooke L, Appathurai A, Lawrance N, Temple-Smith M, Denehy L. 'Probably better than any medication we can give you': General practitioners' views on exercise and nutrition in cancer. Aust J Gen Pract. 2020;49(8):513-8. [DOI:10.31128/AJGP-12-19-5176]

43. Cereda E, Turri A, Klersy C, Cappello S, Ferrari A, Filippi AR, et al. Whey protein isolate supplementation improves body composition, muscle strength, and treatment tolerance in malnourished advanced cancer patients undergoing chemotherapy. Cancer Med. 2019;8(16):6923-32. [DOI:10.1002/cam4.2517]

44. Hoang BV, Tran TT, Duong YT, Nguyen LT, Ngo DQ, Nguyen DV, et al. The Effects of nutrition intervention on postoperative patients with tongue cancer and floor of mouth cancer. J Nutr Sci Vitaminol (Tokyo). 2022;68(6):488-95. [DOI:10.3177/jnsv.68.488]

45. Yeh KY, Wang HM, Chang JW, Huang JS, Lai CH, Lan YJ, et al. Omega-3 fatty acid-, micronutrient-, and probiotic-enriched nutrition helps body weight stabilization in head and neck cancer cachexia. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;116(1):41-8. [DOI:10.1016/j.oooo.2013.01.015]

46. Dai W, Wang SA, Wang K, Chen C, Wang J, Chen X, et al. Impact of nutrition counseling in head and neck cancer sufferers undergoing antineoplastic therapy: a randomized controlled pilot study. Curr Oncol. 2022;29(10):6947-55. [DOI:10.3390/curroncol29100546]

47. Sykes KJ, Gibbs H, Farrokhian N, Arthur A, Flynn J, Shnayder Y, et al. Pilot randomized, controlled, preoperative intervention for nutrition trial in head and neck cancer. Head Neck. 2023;45(1):156-66. [DOI:10.1002/hed.27220]

48. Dechaphunkul T, Arundon T, Raungkhajon P, Jiratrachu R, Geater SL, Dechaphunkul A. Benefits of immunonutrition in patients with head and neck cancer receiving chemoradiation: A phase II randomized, double-blind study. Clin Nutr. 2022;41(2):433-40. [DOI:10.1016/j.clnu.2021.12.035]

49. Barajas-Galindo DE, Vidal-Casariego A, Pintor-de la Maza B, Fernández-Martínez P, Ramos-Martínez T, García-Arias S, et al. Postoperative enteral immunonutrition in head and neck cancer patients: Impact on clinical outcomes. Endocrinol Diabetes Nutr (Engl Ed). 2020;67(1):13-9. https://doi.org/10.1016/j.endinu.2019.05.006 [DOI:10.1016/j.endien.2019.05.004]

50. Della Valle S, Colatruglio S, La Vela V, Tagliabue E, Mariani L, Gavazzi C. Nutritional intervention in head and neck cancer patients during chemo-radiotherapy. Nutrition. 2018;51-52:95-7. [DOI:10.1016/j.nut.2017.12.012]

51. Cereda E, Cappello S, Colombo S, Klersy C, Imarisio I, Turri A, et al. Nutritional counseling with or without systematic use of oral nutritional supplements in head and neck cancer patients undergoing radiotherapy. Radiother Oncol. 2018;126(1):81-8. [DOI:10.1016/j.radonc.2017.10.015]

52. Lages PC, Generoso SV, Correia M. Postoperative symbiotic in patients with head and neck cancer: a double-blind randomised trial. Br J Nutr. 2018;119(2):190-5. [DOI:10.1017/S0007114517003403]

53. Müller-Richter U, Betz C, Hartmann S, Brands RC. Nutrition management for head and neck cancer patients improves clinical outcome and survival. Nutr Res. 2017;48:1-8. [DOI:10.1016/j.nutres.2017.08.007]

54. Azman M, Mohd Yunus MR, Sulaiman S, Syed Omar SN. Enteral glutamine supplementation in surgical patients with head and neck malignancy: A randomized controlled trial. Head Neck. 2015;37(12):1799-807. [DOI:10.1002/hed.23839]

55. Boisselier P, Kaminsky MC, Thézenas S, Gallocher O, Lavau-Denes S, Garcia-Ramirez M, et al. A double-blind phase III trial of immunomodulating nutritional formula during adjuvant chemoradiotherapy in head and neck cancer patients: IMPATOX. Am J Clin Nutr. 2020;112(6):1523-31. [DOI:10.1093/ajcn/nqaa227]

56. Aeberhard C, Mayer C, Meyer S, Mueller SA, Schuetz P, Stanga Z, et al. Effect of preoperative immunonutrition on postoperative short-term outcomes of patients with head and neck squamous cell carcinoma. Head Neck. 2018;40(5):1057-67. [DOI:10.1002/hed.25072]

57. Hanai N, Terada H, Hirakawa H, Suzuki H, Nishikawa D, Beppu S, et al. Prospective randomized investigation implementing immunonutritional therapy using a nutritional supplement with a high blend ratio of ω-3 fatty acids during the perioperative period for head and neck carcinomas. Jpn J Clin Oncol. 2018;48(4):356-61. [DOI:10.1093/jjco/hyy008]

58. Alam S, Lee J, Sahebkar A. Curcumin in Cancer prevention: insights from clinical trials and strategies to enhance bioavailability. Curr Pharm Des. 2024;30(23):1838-51. [DOI:10.2174/0113816128303514240517054617]

59. Zhao C, Zhou X, Cao Z, Ye L, Cao Y, Pan J. Curcumin and analogues against head and neck cancer: From drug delivery to molecular mechanisms. Phytomedicine. 2023;119:154986. [DOI:10.1016/j.phymed.2023.154986]

60. 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. [DOI:10.1186/1476-4598-10-12]

61. Ahmad I, Ahmad S, Ahmad A, Zughaibi TA, Alhosin M, Tabrez S. Curcumin, its derivatives, and their nanoformulations: Revolutionizing cancer treatment. Cell Biochem Funct. 2024;42(1):e3911. [DOI:10.1002/cbf.3911]

62. Abd El-Hack ME, El-Saadony MT, Swelum AA, Arif M, Abo Ghanima MM, Shukry M, et al. Curcumin, the active substance of turmeric: its effects on health and ways to improve its bioavailability. J Sci Food Agric. 2021;101(14):5747-62. [DOI:10.1002/jsfa.11372]

63. Kia SJ, Basirat M, Saedi HS, Arab SA. Effects of nanomicelle curcumin capsules on prevention and treatment of oral mucosits in patients under chemotherapy with or without head and neck radiotherapy: a randomized clinical trial. BMC Complement Med Ther. 2021;21(1):232. [DOI:10.1186/s12906-021-03400-4]

64. Shah S, Rath H, Sharma G, Senapati SN, Mishra E. Effectiveness of curcumin mouthwash on radiation-induced oral mucositis among head and neck cancer patients: A triple-blind, pilot randomised controlled trial. Indian J Dent Res. 2020;31(5):718-27. [DOI:10.4103/ijdr.IJDR_822_18]

65. Mazzarino L, Loch-Neckel G, Bubniak Ldos S, Mazzucco S, Santos-Silva MC, Borsali R, et al. Curcumin-Loaded Chitosan-Coated Nanoparticles as a New Approach for the Local Treatment of Oral Cavity Cancer. J Nanosci Nanotechnol. 2015;15(1):781-91. [DOI:10.1166/jnn.2015.9189]

66. Ramezani V, Ghadirian S, Shabani M, Boroumand MA, Daneshvar R, Saghafi F. Efficacy of curcumin for amelioration of radiotherapy-induced oral mucositis: a preliminary randomized controlled clinical trial. BMC Cancer. 2023;23(1):354. [DOI:10.1186/s12885-023-10730-8]

67. Delavarian Z, Pakfetrat A, Ghazi A, Jaafari MR, Homaei Shandiz F, Dalirsani Z, et al. Oral administration of nanomicelle curcumin in the prevention of radiotherapy-induced mucositis in head and neck cancers. Spec Care Dentist. 2019;39(2):166-72. [DOI:10.1111/scd.12358]

68. Cocetta V, Tinazzi M, Giacomini I, Rosato B, Ragazzi E, Berretta M, et al. Clinical evidence of interaction between nutraceutical supplementation and platinum-based chemotherapy. Curr Med Chem. 2023;30(19):2141-64. [DOI:10.2174/0929867329666220527120237]

69. Filippini T, Malavolti M, Borrelli F, Izzo AA, Fairweather-Tait SJ, Horneber M, et al. Green tea (Camellia sinensis) for the prevention of cancer. Cochrane Database Syst Rev. 2020;3(3):Cd005004. [DOI:10.1002/14651858.CD005004.pub3]

70. Belobrov S, Seers C, Reynolds E, Cirillo N, McCullough M. Functional and molecular effects of a green tea constituent on oral cancer cells. J Oral Pathol Med. 2019;48(7):604-10. [DOI:10.1111/jop.12914]

71. Liao YC, Hsu LF, Hsieh LY, Luo YY. Effectiveness of green tea mouthwash for improving oral health status in oral cancer patients: A single-blind randomized controlled trial. Int J Nurs Stud. 2021;121:103985. [DOI:10.1016/j.ijnurstu.2021.103985]

72. Rafieian N, Azimi S, Manifar S, Julideh H, ShirKhoda M. Is there any association between green tea consumption and the risk of head and neck squamous cell carcinoma: Finding from a case-control study. Arch Oral Biol. 2019;98:280-4. [DOI:10.1016/j.archoralbio.2018.12.003]

73. Radoï L, Paget-Bailly S, Menvielle G, Cyr D, Schmaus A, Carton M, et al. Tea and coffee consumption and risk of oral cavity cancer: results of a large population-based case-control study, the ICARE study. Cancer Epidemiol. 2013;37(3):284-9. [DOI:10.1016/j.canep.2013.02.001]

74. Neetha MC, Panchaksharappa MG, Pattabhiramasastry S, Shivaprasad NV, Venkatesh UG. Chemopreventive synergism between green tea extract and curcumin in patients with potentially malignant oral disorders: a double-blind, randomized preliminary study. J Contemp Dent Pract. 2020;21(5):521-31. [DOI:10.5005/jp-journals-10024-2823]

75. Almatroodi SA, M AA, A SMA, Alhumaydhi FA, Babiker AY, Khan AA, et al. Potential therapeutic targets of resveratrol, a plant polyphenol, and its role in the therapy of various types of cancer. Molecules. 2022;27(9). [DOI:10.3390/molecules27092665]

76. de Sá Coutinho D, Pacheco MT, Frozza RL, Bernardi A. Anti-inflammatory effects of resveratrol: mechanistic insights. Int J Mol Sci. 2018;19(6). [DOI:10.3390/ijms19061812]

77. Mohammadi S, Moghadam MD, Nasiriasl M, Akhzari M, Barazesh M. Insights into the therapeutic and pharmacological properties of resveratrol as a nutraceutical antioxidant polyphenol in health promotion and disease prevention. Curr Rev Clin Exp Pharmacol. 2024;19(4):327-54. [DOI:10.2174/0127724328268507231218051058]

78. Rauf A, Imran M, Butt MS, Nadeem M, Peters DG, Mubarak MS. Resveratrol as an anti-cancer agent: A review. Crit Rev Food Sci Nutr. 2018;58(9):1428-47. [DOI:10.1080/10408398.2016.1263597]

79. Annaji M, Poudel I, Boddu SHS, Arnold RD, Tiwari AK, Babu RJ. Resveratrol-loaded nanomedicines for cancer applications. Cancer Rep (Hoboken). 2021;4(3):e1353. [DOI:10.1002/cnr2.1353]

80. Mohan A, Narayanan S, Sethuraman S, Krishnan UM. Novel resveratrol and 5-fluorouracil coencapsulated in PEGylated nanoliposomes improve chemotherapeutic efficacy of combination against head and neck squamous cell carcinoma. Biomed Res Int. 2014;2014:424239. [DOI:10.1155/2014/424239]

Send email to the article author

Rights and permissions
	This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Designed & Developed by : Yektaweb