Frankincense (Boswellia serrata) for the Management of Cerebral Edema in Brain Tumor Patients: A Systematic Review

Abstract

Introduction: Cerebral edema is a common and life-threatening complication in patients with brain tumors, often managed with corticosteroids. Boswellia serrata extract (frankincense) has anti-inflammatory properties and has been investigated as an alternative treatment. This review assesses its efficacy.

Methods: We searched multiple databases for clinical trials that evaluated the effect of Boswellia serrata extract on peritumoral brain edema in patients with gliomas or brain metastases. The primary outcome was the reduction in edema volume measured by MRI.

Results: Four clinical trials met the inclusion criteria. In a key RCT, treatment with a Boswellia extract resulted in a significant reduction in cerebral edema in over 60% of patients undergoing radiotherapy, often leading to a reduction in corticosteroid requirements. The treatment was very well tolerated.

Discussion: Boswellia serrata appears to be an effective agent for reducing cerebral edema in brain tumor patients. Its mechanism is distinct from corticosteroids and is related to the inhibition of leukotriene synthesis. This offers a valuable alternative or adjunct with fewer side effects.

Conclusion: Boswellia serrata is a promising and safe herbal option for managing peritumoral edema in brain tumor patients.