Boswellia serrata acts on cerebral edema in patients irradiated for brain tumors

In Cancer this week:

An interesting randomized trial looking at the use of Boswelliaserrata (an extract of Indian Frankincense) on cerebral edema, for patients undergoing radiation therapy for brain tumors (metastatic or primary). It is a modest trial with only 22pts in each arm, but they were able to demonstrate a significant decrease in T2 signal volume with the extract vs placebo. This did not however translate into a reduction in the use of steroids, nor in any clinically relevant endpoint. Of course, confirmation will be needed before this is ready for prime time, but this study is an intriguing demonstration of a novel approach at limiting steroid use.

Link and Abstract.

Boswellia serrata acts on cerebral edema in patients irradiated for brain tumors: "

Abstract

BACKGROUND:

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.

METHODS:

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).

RESULTS:

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.

CONCLUSIONS:

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.

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