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Prophylactic and therapeutic effects of honey on radiochemotherapy-induced mucositis: a meta-analysis of randomized controlled trials

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Abstract

Purpose

Oral mucositis is a common side effect of radiochemotherapy and may adversely affect the patients’ quality of life (QoL). Honey application may reduce the mucositis grade in patients. Here, we conducted a meta-analysis of randomized controlled trials (RCTs) to evaluate the prophylactic and therapeutic effects of honey on radiochemotherapy-induced oral mucositis.

Methods

Publications on RCTs were extracted from the PubMed, Embase, CINAHL, and Cochrane Library databases. The primary outcomes were mucositis grades and pain scores. Secondary outcomes were the recovery time and QoL. The study was registered with PROSPERO (number CRD42018108486).

Results

Nineteen RCTs, involving 1276 patients, were reviewed. Honey considerably mitigated oral mucositis in both prophylactic and therapeutic phases. In the prophylactic phase, intolerable mucositis development was significantly prevented in the honey-treated group (RR = 0.18, 95% confidence interval [CI] = 0.09 to 0.41). Patients treated with honey showed significant decrease in pain scores in the first month of treatment (weighted mean difference [WMD] = − 3.25, 95% CI = − 4.41 to − 2.09) and at the end of the treatment (WMD = − 2.32, 95% CI = − 4.47 to − 0.18).

Conclusion

Honey, which is relatively cheap and easily available, prevented mucositis and effectively mitigate mucositis in patients after radiochemotherapy. Moreover, it significantly reduced the mucositis grade and engendered a fast and painless healing process. Therefore, honey use during and after radiochemotherapy is recommended for mucositis prevention and treatment.

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Funding

This study was funded by Taipei Medical University of Taiwan (grant number TMU106-AE1-B13).

Author information

Author notes

  1. Tzu-Ming Liu and Yu-Wei Luo contributed equally to this work.

Authors and Affiliations

  1. School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Tzu-Ming Liu & Yu-Wei Luo

  2. Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan

    Ka-Wai Tam

  3. Department of Medical Research, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan

    Ka-Wai Tam

  4. Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Ka-Wai Tam

  5. Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan

    Ka-Wai Tam

  6. Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan

    Ka-Wai Tam & Tsai-Wei Huang

  7. School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan

    Chia-Chin Lin & Tsai-Wei Huang

  8. School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong

    Chia-Chin Lin

  9. Alice Ho Miu Ling Nethersole Charity Foundation, Tai Po, Hong Kong

    Chia-Chin Lin

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  1. Tzu-Ming Liu
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Correspondence to Tsai-Wei Huang.

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Liu, TM., Luo, YW., Tam, KW. et al. Prophylactic and therapeutic effects of honey on radiochemotherapy-induced mucositis: a meta-analysis of randomized controlled trials. Support Care Cancer 27, 2361–2370 (2019). https://doi.org/10.1007/s00520-019-04722-3

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  • DOI: https://doi.org/10.1007/s00520-019-04722-3

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