Effectiveness of natural-based products for radiation-induced oral mucositis therapy: A systematic review.

2023
Cancer treatment and research communications 36
- Zulfa Fidi Pranadwista
- Nanan Nur'aeny

PubMed: 37209466
DOI: 10.1016/j.ctarc.2023.100720

Study Design

Type: Systematic Review
Population: HNC patients who had oral mucositis after receiving radiation or chemical therapy
Methods: Systematic review following PRISMA guidelines; searches in Pubmed, ScienceDirect, and Ebscohost-CINAHL Plus; inclusion of RCTs published 2012–2022 evaluating NBPs therapy

Radiation-induced oral mucositis (RIOM) is one of the common toxic reactions from ionizing radiation and normal tissue injuries as a complication of radiation therapy and chemotherapy. Radiation therapy is an option for the treatment of head and neck cancer (HNC). The use of natural products is an alternative therapy for RIOM. This review aimed to describe the effectiveness of natural-based products (NBPs) in reducing the severity, pain score, incidence, oral lesion size, and other symptoms such as dysphagia, dysarthria, and odynophagia. This systematic review follows the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. Pubmed, ScienceDirect, and Ebscohost-CINAHL Plus databases were used for article searches. The inclusion criteria were studies published from 2012 to 2022 with full text available, in English, a study in humans, and a Randomized Clinical Trial (RCT) that evaluate the effect of NBPs therapy in RIOM patients diagnosed with HNC. This study's population was HNC patients who had oral mucositis after receiving radiation or chemical therapy. The NBPs were manuka honey, thyme honey, aloe vera, calendula, zataria multiflora, Plantago major L., and turmeric. Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as a decrease in severity, incidence rate, pain score, oral lesion size, and the other symptoms of oral mucositis such as dysphagia and burning mouth syndrome. This review concludes that NBPs therapy is effective for RIOM in HNC patients.

Research Insights

Aloe Vera→Reduced Burning Mouth Syndrome
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as ... burning mouth syndrome
Effect
Beneficial
Effect size
Moderate
Aloe Vera→Reduced Dysphagia
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as ... dysphagia
Effect
Beneficial
Effect size
Moderate
Aloe Vera→Reduced Oral Lesion Size
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as a decrease in ... oral lesion size
Effect
Beneficial
Effect size
Moderate
Aloe Vera→Reduced Oral Mucositis Severity
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as a decrease in severity
Effect
Beneficial
Effect size
Moderate
Aloe Vera→Reduced Pain
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as a decrease in ... pain score
Effect
Beneficial
Effect size
Moderate
Calendula→Reduced Burning Mouth Syndrome
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as ... burning mouth syndrome
Effect
Beneficial
Effect size
Moderate
Calendula→Reduced Dysphagia
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as ... dysphagia
Effect
Beneficial
Effect size
Moderate
Calendula→Reduced Oral Lesion Size
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as a decrease in ... oral lesion size
Effect
Beneficial
Effect size
Moderate
Calendula→Reduced Oral Mucositis Severity
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as a decrease in severity
Effect
Beneficial
Effect size
Moderate
Calendula→Reduced Pain
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as a decrease in ... pain score
Effect
Beneficial
Effect size
Moderate
Manuka Honey→Reduced Burning Mouth Syndrome
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as ... burning mouth syndrome
Effect
Beneficial
Effect size
Moderate
Manuka Honey→Reduced Dysphagia
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as ... dysphagia
Effect
Beneficial
Effect size
Moderate
Manuka Honey→Reduced Oral Lesion Size
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as a decrease in ... oral lesion size
Effect
Beneficial
Effect size
Moderate
Manuka Honey→Reduced Oral Mucositis Severity
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as a decrease in severity
Effect
Beneficial
Effect size
Moderate
Manuka Honey→Reduced Pain
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as a decrease in ... pain score
Effect
Beneficial
Effect size
Moderate
Turmeric→Reduced Burning Mouth Syndrome
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as ... burning mouth syndrome
Effect
Beneficial
Effect size
Moderate
Turmeric→Reduced Dysphagia
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as ... dysphagia
Effect
Beneficial
Effect size
Moderate
Turmeric→Reduced Oral Lesion Size
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as a decrease in ... oral lesion size
Effect
Beneficial
Effect size
Moderate
Turmeric→Reduced Oral Mucositis Severity
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as a decrease in severity
Effect
Beneficial
Effect size
Moderate
Turmeric→Reduced Pain
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as a decrease in ... pain score
Effect
Beneficial
Effect size
Moderate
plantain leaf→Reduced Burning Mouth Syndrome
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as ... burning mouth syndrome
Effect
Beneficial
Effect size
Moderate
plantain leaf→Reduced Dysphagia
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as ... dysphagia
Effect
Beneficial
Effect size
Moderate
plantain leaf→Reduced Oral Lesion Size
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as a decrease in ... oral lesion size
Effect
Beneficial
Effect size
Moderate
plantain leaf→Reduced Oral Mucositis Severity
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as a decrease in severity
Effect
Beneficial
Effect size
Moderate
plantain leaf→Reduced Pain
Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as a decrease in ... pain score
Effect
Beneficial
Effect size
Moderate