Therapeutic Interventions to Manage Oral Mucositis and Their Impact on Quality of Life in Cancer Patients: An Umbrella Review.

2026-02-03
Pain research & management 2026
- Joatan Lucas de Sousa Gomes Costa
- Leonardo Díaz
- Alain Chaple Gil
- Gonzalo Rodríguez Martínez
- Rodrigo Cabello Ibacache
- Cristian Bersezio Miranda
- Alfredo Von Marttens
- Javier Basualdo
- Eduardo Fernández Godoy
- Milton Carlos Kuga

PubMed: 41647299
DOI: 10.1155/prm/3601001

Study Design

Type: Systematic Review
Methods: An umbrella review was conducted following PRISMA 2020 and Joanna Briggs Institute (JBI) guidelines. Five databases (PubMed, Embase, Scopus, Web of Science, and Cochrane Library) were searched from inception to March 2024.

Background

Oral mucositis (OM) is a debilitating complication of cancer therapy, particularly in head and neck cancer patients, with significant adverse effects on quality of life (QoL). Although numerous interventions have been investigated, their impact on QoL remains inconsistently reported and poorly synthesized.

Methods

An umbrella review was conducted following PRISMA 2020 and Joanna Briggs Institute (JBI) guidelines. Five databases (PubMed, Embase, Scopus, Web of Science, and Cochrane Library) were searched from inception to March 2024. Reviews were eligible if they evaluated any therapeutic intervention for OM and reported QoL-related outcomes using validated tools. Methodological quality was appraised using AMSTAR 2, and findings were narratively synthesized and thematically categorized. The protocol was registered in PROSPERO (CRD420251044088).

Results

Eight systematic reviews (257 primary studies) met the inclusion criteria. Photobiomodulation, honey, black mulberry, and botanical agents such as SAMITAL showed consistent improvement in QoL domains, including pain relief, oral function, and emotional well-being. Gabapentin demonstrated potential in reducing opioid use and early mucositis-related pain, though findings were mixed across trials. QoL was most commonly assessed using the EORTC QLQ-C30, FACT-HN, and UW-QOL. Overall, heterogeneity in intervention protocols and QoL instruments limited comparability.

Conclusions

This review highlights the most promising interventions for improving QoL in patients with OM. Standardizing QoL measurement and prioritizing patient-reported outcomes in future trials is essential to inform evidence-based supportive oncology care.

Research Insights

Honey→Improved Emotional Well-being
Photobiomodulation, honey, black mulberry, and botanical agents such as SAMITAL showed consistent improvement in QoL domains, including pain relief, oral function, and emotional well-being.
Effect
Beneficial
Effect size
Small
Honey→Improved Oral Function
Photobiomodulation, honey, black mulberry, and botanical agents such as SAMITAL showed consistent improvement in QoL domains, including pain relief, oral function, and emotional well-being.
Effect
Beneficial
Effect size
Small
Honey→Reduced Pain
Photobiomodulation, honey, black mulberry, and botanical agents such as SAMITAL showed consistent improvement in QoL domains, including pain relief, oral function, and emotional well-being.
Effect
Beneficial
Effect size
Small
Mulberry→Improved Emotional Well-being
Photobiomodulation, honey, black mulberry, and botanical agents such as SAMITAL showed consistent improvement in QoL domains, including pain relief, oral function, and emotional well-being.
Effect
Beneficial
Effect size
Small
Mulberry→Improved Oral Function
Photobiomodulation, honey, black mulberry, and botanical agents such as SAMITAL showed consistent improvement in QoL domains, including pain relief, oral function, and emotional well-being.
Effect
Beneficial
Effect size
Small
Mulberry→Reduced Pain
Photobiomodulation, honey, black mulberry, and botanical agents such as SAMITAL showed consistent improvement in QoL domains, including pain relief, oral function, and emotional well-being.
Effect
Beneficial
Effect size
Small