Effects of honey use on the management of radio/chemotherapy-induced mucositis: a meta-analysis of randomized controlled trials

Xu, Jin; Xia, Rong; Sun, Zihuan; Sun, Lei; Xi, Min; Liu, C.; Zhang, H.; Zhu, Yi

doi:10.1016/j.ijom.2016.04.023

Cited by 50 publications

(35 citation statements)

References 31 publications

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“…Although some standard guidelines for management are available (7,8), reliable and effective treatments are lacking (9). For mucositis, intensive oral care protocols, antimicrobial agents, anti-inflammatory agents, cytoprotective agents, recombinant keratinocyte growth factor-1, nutritional supplements, biostimulant agents or natural and homeopathic agents have been described (10)(11)(12)(13). On the other hand, several topical or systemic formulations have been tried for dermatitis, all of them with ineffective results (5,6).…”

Section: Introductionmentioning

confidence: 99%

Double-blind randomized study of oral glutamine on the management of radio/chemotherapy-induced mucositis and dermatitis in head and neck cancer

Lopez‐Vaquero

Gutiérrez-Bayard

Rodríguez-Ruiz

et al. 2017

Molecular and Clinical Oncology

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Abstract. This randomized clinical trial was designed to determine whether glutamine administration was effective in reducing the incidence and severity of mucositis and dermatitis induced by radiotherapy (RT) or chemoradiotherapy (CHRT) in patients with head and neck cancer (HNC). Fifty patients were randomized to receive orally either L-Glutamine or placebo (25 patients in each arm). In the glutamine-treated group, 10 g of oral glutamine was administered three times daily. The primary endpoint was to compare the appearance of clinical mucositis between groups at the 6th week, according to the Common Terminology Criteria for Adverse Events. Secondary endpoints were: Functional mucositis, mucositis onset, cervicofacial dermatitis, pain, weight loss and assessment of quality of life (according to the M.D. Anderson Symptom Inventory-Head and Neck). In total, 76 and 87.5% developed clinical mucositis in the glutamine and placebo group, respectively. The incidence and severity grade of mucositis at the 6th week did not exhibit statistically significantly differences between the two groups, although it had a higher value in the placebo group. Significant reduction of dermatitis incidence (P=0.038) and severity (P=0.032) was found in the glutamine group. There were no differences in other outcomes such as pain, weight loss and mucositis onset, in treatment parameters including concomitant chemotherapy, radiation dose and previous surgery, or in quality of life. The present study revealed that glutamine provided slight clinical effects compared with placebo in terms of reducing oral mucositis induced by RT or CHRT in patients with HNC at the 6th week; however, the results were not statistically significant. Although the findings suggested a significant benefit in reducing the incidence and severity of dermatitis, further confirmatory studies are required. IntroductionRadiation therapy (RT) and concomitant chemoradiotherapy (CHRT) in patients with head and neck cancer (HNC) are commonly associated with complications such as mucositis and dermatitis in the oral cavity and on the cervicofacial area. Clinically, these adverse effects are able to cause severe pain and odinophagia, increase the risk of infections, skin wounds and inflammatory ulcers, limit deglutition, cause malnutrition and negatively impact the diet and overall quality of life of patients (1). The incidence rate of mucositis varies between 85 and 100%, depending on the cancer treatment regimen, with altered fractionated RT, CHRT or conventional RT (2,3), whereas the incidence of acute dermatitis varies between 7 and 25% (4,5), reaching up to 49% in patients receiving RT in combination with cetuximab (6).Numerous efforts have been made to identify effective agents for preventing and treating mucositis and dermatitis induced by RT or CHRT. Although some standard guidelines for management are available (7,8), reliable and effective treatments are lacking (9). For mucositis, intensive oral care protocols, antimicrobial agents, anti-inflammatory agents, cytopro...

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Section: Introductionmentioning

confidence: 99%

Double-blind randomized study of oral glutamine on the management of radio/chemotherapy-induced mucositis and dermatitis in head and neck cancer

Lopez‐Vaquero

Gutiérrez-Bayard

Rodríguez-Ruiz

et al. 2017

Molecular and Clinical Oncology

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“…Met analyses have substantiated the observed beneficial effects [ 13 , 14 , 15 ]. Honey is arguably one of the world’s oldest dietary agents with medicinal use, and scientific studies have shown it to possess wound healing, antimicrobial, analgesic, and anti-inflammatory effects in various experimental studies [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. The present study was principally carried out to observe whether honey interfered with the radiation-induced tumor response while having a positive effect against oral mucositis.…”

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

“…In the recent past, studies from around the world have shown that honey was effective at mitigating radiation- and chemotherapy-induced mucositis [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. Met analyses have substantiated the observed beneficial effects [ 13 , 14 , 15 ]. Honey is arguably one of the world’s oldest dietary agents with medicinal use, and scientific studies have shown it to possess wound healing, antimicrobial, analgesic, and anti-inflammatory effects in various experimental studies [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Honey Mitigates Radiation-Induced Oral Mucositis in Head and Neck Cancer Patients without Affecting the Tumor Response

Rao

Hegde

Rao

et al. 2017

Foods

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Radiation-induced mucositis is a dose-limiting factor in the effective treatment of head and neck (H & N) cancers. The objective of this study was to understand the efficacy of honey in mitigating radiation-induced mucositis and whether it would interfere with tumor control. This was a single-blinded, randomized, controlled study and was carried out in patients with H & N cancer requiring curative radiotherapy (>62 Gy (Gray)). The patients meeting the inclusion criteria were randomly assigned to receive either honey (n = 25) or povidone-iodine (active comparator) (n = 25) during radiotherapy. Oral mucositis was assessed using the RTOG (Radiation Therapy Oncology Group) grading system before the start, during, and at the end of the treatment by an investigator unaware of the treatment. The results indicate that when compared with the active comparator, honey reduced the radiation-induced oral mucositis, decreased the incidence of intolerable mucositis, treatment breaks, loss of treatment days (p < 0.0001 and < 0.0003) and did not affect the radiation-induced tumor response. The clinical observations indicate that honey mitigates the radiation-induced mucositis and does not interfere with tumor cell killing.

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“…Thus, considering the physicochemical and medicinal known properties, their potential use by the pharmaceutical and cosmetic industries has significantly increased. Honey has been used to prevent, and treat patients with, oral mucositis resulting from radio/chemotherapy [5,6], to reduce esophagitis induced by chemoradiation therapy during the treatment of lung cancer [7], to treat skin ulcer [8,9] and to treat acute irritating cough [10]. Also, due to the recognized antibacterial activity of honey [11][12][13][14] its potential application in wound healing and tissue engineering has been studied [15,16], as for example for the treatment of burns and skin disorders [12,17].…”

Section: Introductionmentioning

confidence: 99%

Honey Evaluation Using Electronic Tongues: An Overview

et al. 2018

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Honey-rich composition in biologically active compounds makes honey a food products highly appreciated due to the nutritional and healthy properties. Food-manufacturing is very prone to different types of adulterations and fraudulent labelling making it urgent to establish accurate, fast and cost-effective analytical techniques for honey assessment. In addition to the classical techniques (e.g., physicochemical analysis, microscopy, chromatography, immunoassay, DNA metabarcoding, spectroscopy), electrochemical based-sensor devices have arisen as reliable and green techniques for food analysis including honey evaluation, allowing in-situ and on-line assessment, being a user-friendly procedure not requiring high technical expertise. In this work, the use of electronic tongues, also known as taste sensor devices, for honey authenticity and assessment is reviewed. Also, the versatility of electronic tongues to qualitative (e.g., botanical and/or geographical origin assessment as well as detection of adulteration) and quantitative (e.g., assessment of adulterants levels, determination of flavonoids levels or antibiotics and insecticides residues, flavonoids) honey analysis is shown. The review is mainly focused on the research outputs reported during the last decade aiming to demonstrate the potentialities of potentiometric and voltammetric multi-sensor devices, pointing out their main advantages and present and future challenges for becoming a practical quality analytical tool at industrial and commercial levels.

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Effects of honey use on the management of radio/chemotherapy-induced mucositis: a meta-analysis of randomized controlled trials

Cited by 50 publications

References 31 publications

Double-blind randomized study of oral glutamine on the management of radio/chemotherapy-induced mucositis and dermatitis in head and neck cancer

Double-blind randomized study of oral glutamine on the management of radio/chemotherapy-induced mucositis and dermatitis in head and neck cancer

Honey Mitigates Radiation-Induced Oral Mucositis in Head and Neck Cancer Patients without Affecting the Tumor Response

Honey Evaluation Using Electronic Tongues: An Overview

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