الفهرس 
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Abstract
Oral squamous cell carcinoma (OSCC) is still one of the most difficult malignancies to control because of its high capability for local invasion and metastasis. Even though the improvements in therapeutic strategies (surgery followed by combined radio-chemotherapy), the prognosis is still poor. The survival rates have not changed during the last 20 years, with high mortality rates.
Herbal medicine is the fulcrum of complementary and alternative medicine. It is gaining popularity around the world, and it has been lately introduced into the mainstream healthcare systems. Natural products have sparked widespread interest in cancer prevention and therapy since they are less expensive, more widely available, highly potent and non-toxic with less side effects than synthetic medications. One of the promising herbal candidates is Fagonia arabica; it exhibits an exceptional anticancer activity through inhibition of proliferation, induction of apoptosis, arrest of the cell cycle, and preventing invasion, all while having no deleterious effect on the neighboring healthy cells.
The aim of the current study was to assess the anticancer effect of Fagonia arabica shoot ethanolic extract (FASEE) versus cisplatin against oral squamous cell carcinoma cell line through cytotoxic assay to calculate and verify the IC50, flow cytometer assay was used to detect proliferation, apoptosis, and cell cycle arrest, and the scratch wound healing assay was used to determine the antimigratory effect.
The cytotoxic effect of FASEE was in a dose-dependent manner, by increasing the concentration of FASEE, the cell viability continued to decrease significantly. Moreover, cisplatin at low concentrations revealed a significant decrease in cell viability which was also manifested in a dose-dependent manner.
The proliferation marker ki-67 and the apoptosis marker annexin V were assessed by flow cytometry for the SCC-4 cells incubated with FASEE. Correlation between the results proved that FASEE reduced cell proliferation to ” ” ” " ~ " ” ” ”52% and enhanced cell death in SCC-4 cells which was translated mainly as late apoptosis. In comparison to cisplatin, the flow cytometer results revealed reduction of cell proliferation to ” ” ” " ~ " ” ” ”69% and enhanced cell death in SCC-4 cells which was translated mainly as early apoptosis.
The flow cytometer results of FASEE for cell cycle analysis revealed that most of the cell population was arrested in the G0/G1 phase after 48 hours incubation period. On the contrary, cisplatin treated cells revealed most of the cell population was arrested in the G2/M phase after 48 hours incubation period.
The anti-migratory results revealed a significant increase in the wound gap in the FASEE treated group after 24h and 48h incubation period. The cytotoxic effect of FASEE led to cell death, therefore there was increase in the width of the cell free zone. In the cisplatin-treated group, the width of the cell-free zone slightly decreased after 24h and 48h incubation.
from the results of the current study, FASEE proved a strong anti-tumorigenic effect against oral squamous cell carcinoma cell line. This promising herbal candidate opens a new gate in combating cancer, overcoming the unavoidable deleterious side effects of the traditional method of cancer treatment. FASEE has a comparable potent cytotoxic effect to cisplatin against oral cancer cells, which was proven by a significant reduction of proliferation when compared with cisplatin. Also, FASEE and cisplatin resulted in a remarkable cell death in SCC-4 cells both translated as apoptosis. Moreover, in the Fagonia arabica treated group most of the cell population was arrested in the G0/G1 phase, however, in the cisplatin treated group, the cell population was arrested mainly in the G2/M phase. Last but not least, Fagonia arabica proved to have a superior anti-migratory effect against oral cancer cells, when compared to cisplatin.