Effects of honey on oral mucositis in patients with head and neck cancer: A meta-analysis.

OBJECTIVES/HYPOTHESIS The objective of this study was to perform a meta-analysis of the efficacy of honey in the management of oral mucositis during radiotherapy in patients with head and neck cancer. STUDY DESIGN Meta-analysis using MEDLINE, Scopus, and the Cochrane Library as data sources. METHODS Two authors independently searched the databases for relevant studies from inception to June 2014. Included in the meta-analysis were randomized controlled studies published in English comparing the oral administration of honey (honey group) with placebo or no treatment (control group) in patients with head and neck cancer who were undergoing radiotherapy or chemoradiotherapy. Excluded studies failed to report quantifiable outcome measures regarding oral mucositis. Outcomes of interest included the degree and incidence of mucositis, incidence of microbial colonization, and weight loss. RESULTS Nine studies comprising 476 patients were included in the meta-analysis. The incidence of moderate to severe mucositis and the mean mucositis grade during the first 3 weeks of therapy were significantly lower in the honey group than the control group. Additionally, the onset of mucositis was significantly later in the honey group than the control. Although there were no significant differences in the incidences of microbial colonization and pain experienced between the two groups, the incidence of weight loss was significantly lower in the honey group than control group. CONCLUSIONS Oral administration of honey after radiotherapy could prevent moderate to severe mucositis and associated weight loss. However, because our results were based on an analysis of a small number of trials, further trials are required to confirm these results. LEVEL OF EVIDENCE NA.