Abstract
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.
Highlights
Mucositis is an unavoidable side effect observed in most cancer patients undergoing radiotherapy for head and neck cancers (H & N) [1]
Patients who had had oral surgery less than six weeks previously, those who had had chemotherapy within the past six weeks, and those who had previously been treated with radiotherapy for H & N cancers were excluded from the study
In the present study honey was observed to be effective at mitigating radiation mucositis, which is in agreement to earlier reports [2,3,4,5,6,7,8,9,10,11,12,13,14,15]
Summary
Mucositis is an unavoidable side effect observed in most cancer patients undergoing radiotherapy for head and neck cancers (H & N) [1]. Oral mucositis is classified as tolerable (grade 1 and 2 mucositis) and intolerable mucositis (grade 3 or 4) [1]. Mucositis contributes to local and systemic infections [1]. This will affect the treatment schedule, dose, and therapeutic outcome [1]. There are no drugs for the avoidance/mitigation of radiation-induced mucositis and preventive procedures consist of symptom management and adherence to basic oral care to prevent infections and alleviate the mucosal symptoms [1]. In most hospitals colloidal silver solutions, salt and soda rinses, or hydrogen peroxide
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