{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T23:32:50Z","timestamp":1761175970202,"version":"build-2065373602"},"reference-count":12,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T00:00:00Z","timestamp":1750291200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Treatment related toxicities for management of cancer lead to significant deterioration in the quality of life, increased morbidity, hospital admissions, and increased treatment interruptions. We carried out this study, to reduce treatment related toxicities without compromising treatment efficacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Evaluate L\u2010carnitine in reducing toxicities in HNSCC patients undergoing concurrent chemoradiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>Study conducted in the Department of Radiotherapy tertiary care center in Northern India from August 2018 to 2020. All patients were randomized into the study arm and control arm; the study arm received oral L\u2010carnitine 500\u2009mg thrice daily, with symptomatic treatment for chemoradiotherapy\u2010induced toxicity. The control arm received only symptomatic treatment for chemoradiation\u2010induced toxicities. Toxicity assessment was done biweekly during treatment using RTOG (Radiation Therapy Oncology Group) criteria for toxicity assessment. Nutritional assessment was done by comparing hemoglobin, albumin, and weight loss during treatment. Fatigue was assessed using the Brief Fatigue Inventory (BFI) and the quality of life was assessed using the EORTC\u2010QLQ\u2010C30 questionnaire. Response evaluation for the primary tumor and neck nodes was done using RECIST 1.1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significant decrease in severity and delay in onset of dermatitis, mucositis, laryngeal reactions, and dysphagia were observed; however, no such benefit was seen in xerostomia. Treatment response was comparable in both arms. Mean post\u2010treatment BFI in the test arm versus control arm was 37.22 and 52.24 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value 0.042), respectively. 28.75% of patients in the control arm and none in the study arm had albumin levels &lt;\u20093.4\u2009g\/dL. Median weight loss in the test arm was 5.2% and in the control arm was 7.4%. Hospital admission was significantly less in the test arm.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>L\u2010carnitine can be given to HNSCC patients receiving concurrent chemoradiation to lessen treatment related toxicity, but larger, multicentric randomized trials required to substantiate this conclusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.28221","type":"journal-article","created":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T05:31:26Z","timestamp":1750311086000},"page":"3039-3046","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["L\u2010Carnitine to Reduce Chemoradiotherapy\u2010Induced Toxicity in Head and Neck Cancer: A Randomized Study"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5446-5896","authenticated-orcid":false,"given":"Kumari","family":"Puja","sequence":"first","affiliation":[{"name":"Department of Radiotherapy All India Institute of Medical Sciences  Deoghar India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamna","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Biochemistry S.N Medical College  Agra India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Indira","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy VCSGMC  Srinagar India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashok Kumar","family":"Arya","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy S.N Medical College  Agra India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,19]]},"reference":[{"volume-title":"The Health of the People: What Works: The African Regional Health Report 2014","year":"2014","author":"World Health Organization Regional Office for Africa","key":"e_1_2_8_2_1"},{"doi-asserted-by":"publisher","key":"e_1_2_8_3_1","DOI":"10.1016\/S0140-6736(16)31012-1"},{"doi-asserted-by":"publisher","key":"e_1_2_8_4_1","DOI":"10.1203\/00006450-198702000-00018"},{"doi-asserted-by":"publisher","key":"e_1_2_8_5_1","DOI":"10.25258\/ijpqa.10.4.32"},{"issue":"2","key":"e_1_2_8_6_1","first-page":"S8","article-title":"Primary and Secondary Carnitine Deficiency Syndromes","volume":"10","author":"Pons R.","year":"1995","journal-title":"Journal of Child Neurology"},{"doi-asserted-by":"publisher","key":"e_1_2_8_7_1","DOI":"10.4161\/oxim.3.3.12106"},{"doi-asserted-by":"publisher","key":"e_1_2_8_8_1","DOI":"10.1007\/s11064-007-9403-0"},{"doi-asserted-by":"publisher","key":"e_1_2_8_9_1","DOI":"10.1016\/j.drudis.2010.03.014"},{"doi-asserted-by":"publisher","key":"e_1_2_8_10_1","DOI":"10.1016\/j.mam.2004.06.003"},{"doi-asserted-by":"publisher","key":"e_1_2_8_11_1","DOI":"10.1007\/s12035-013-8498-3"},{"doi-asserted-by":"publisher","key":"e_1_2_8_12_1","DOI":"10.1515\/med-2017-0028"},{"issue":"3","key":"e_1_2_8_13_1","first-page":"413","article-title":"L\u2010Carnitine Supplementation Reduces the General Fatigue of Cancer Patients During 86.Chemotherapy","volume":"8","author":"Matsui H.","year":"2018","journal-title":"Molecular and Clinical Oncology"}],"container-title":["Head &amp; Neck"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.28221","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T09:26:17Z","timestamp":1761125177000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hed.28221"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,19]]},"references-count":12,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1002\/hed.28221"],"URL":"https:\/\/doi.org\/10.1002\/hed.28221","archive":["Portico"],"relation":{},"ISSN":["1043-3074","1097-0347"],"issn-type":[{"type":"print","value":"1043-3074"},{"type":"electronic","value":"1097-0347"}],"subject":[],"published":{"date-parts":[[2025,6,19]]},"assertion":[{"value":"2025-01-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}