The effect of topical application of pure honey on radiation-induced mucositis: A randomized clinical trial

Department of Oral Medicine of Faculty of Dentistry at Babol University of Medical Sciences in Babol, Iran.
The journal of contemporary dental practice 02/2008; 9(3):40-7.
Source: PubMed


Radiation-induced mucositis is an early effect of head and neck radiotherapy. Mucositis can cause ulcers, and patients may experience pain and dysphasia which need treatment. The aim of this study is to evaluate the effect of pure natural honey on radiation induced mucositis.
In this randomized single blind (examiner blind) clinical trial 40 patients with head and neck cancer requiring radiation to the oropharyngeal mucosa were randomly assigned to two groups. Twenty patients assigned to the study group received honey, while both the study and control groups received standard head and neck radiation therapy based on a standard protocol. In the study group patients were instructed to take 20 ml of honey 15 minutes before radiation therapy, then again at intervals of 15 minutes and six hours after radiation. In the control group patients were instructed to rinse with 20 ml of saline before and after radiation. Patients were evaluated weekly for progression of mucositis using the Oral Mucositis Assessing Scale (OMAS). Data were analyzed using the independent t-test, Mann-Whitney, and Friedman tests.
A significant reduction in mucositis among honey-received patients compared with controls (p=0.000) occurred.
Within the limits of this study the results showed the application of natural honey is effective in managing radiation induced mucositis.
Natural honey is a product with rich nutritional qualities that could be a pleasant, simple, and economic modality for the management of radiation mucositis.

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Available from: Mina Motallebnejad, Jan 18, 2014
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    • "underlying systemic disease and race, as well as tissue specific factors [40] Although the effects of patients' age, cancer stage and gender on the oral mucositis of head and neck cancer are not clear, these are some of the characteristics that have to be collated to this systematic review. In three of the studies [39] [40] [41] the mean age of the participants ranged from 54 to 60 years, in one study it was 48 years [39] while one study only mentioned an overall age division which covered > or < 40 years [38]. "
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    ABSTRACT: Aim: To evaluate the effectiveness of honey in the management of oral mucositis in head and neck cancer patients undergoing radiotherapy. Methods: The review of the literature was based on a keyword strategy and pre-determined inclusion and exclusion criteria. The keywords "head and neck cancer", "radiotherapy", "oral mucositis", "controlled trial" and "honey" were used as search terms in the EMBASE, CINAHL, COCHRANE and PUBMED databases. The citation and reference list of the eligible articles were also screened for potentially relevant articles. The methodological quality of the selected trials was assessed by the JADAD scale. Results: In total, 5 studies met the criteria and were included in the systematic review. Three studies assessed the effectiveness of honey against other products including golden syrup, lignocaine and saline and two studies assessed the effectiveness of honey against standard treatment regimes. Four out of the five studies demonstrated significant reduction in the mucositis levels and one study reported that honey had no statistical association with less severe mucositis. Methodologically the quality of most studies was moderate due to the small sample size, which might impact upon the significance of the findings. Conclusions: Although honey appears to be a simple, affordable, available and cost-effective treatment for the management of radiation-induced oral mucositis, there is a need for further multi-centre randomized trials to validate these findings.
    Full-text · Article · Jun 2013 · European Journal of Integrative Medicine
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    • "Motallebnejad et. al. (2008) reported that application of natural honey is effective in managing radiation induced mucositis (63). "
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    ABSTRACT: Honey is a by-product of flower nectar and the upper aero-digestive tract of the honey bee, which is concentrated through a dehydration process inside the bee hive. Honey has a very complex chemical composition that varies depending on the botanical source. It has been used both as food and medicine since ancient times. Human use of honey is traced to some 8000 years ago as depicted by Stone Age paintings. In addition to important role of natural honey in the traditional medicine, during the past few decades, it was subjected to laboratory and clinical investigations by several research groups and it has found a place in modern medicine. Honey has been reported to have an inhibitory effect on around 60 species of bacteria, some species of fungi and viruses. Antioxidant capacity of honey is important in many disease conditions and is due to a wide range of compounds including phenolics, peptides, organic acids, enzymes, and Maillard reaction products. Honey has also been used in some gastrointestinal, cardiovascular, inflammatory and neoplastic states. This review covers the composition, physico-chemical properties and the most important uses of natural honey in human diseases.
    Full-text · Article · Jun 2013 · Iranian Journal of Basic Medical Science
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    • "Several strategies are being actively investigated, which are based on the mechanistic interruption of one or more pathobiological pathways involved in this condition [5]. A large number of treatments and strategies have been studied for OM such as, growth factors, cytokines, antibiotics, anti-inflammatory agents, cryotherapy, mucosal protectors [6,7] and traditional therapy such as pure honey [8] and herbal medicines [9]. As an example, it has been shown that chamomile mouthwash, is fairly effective on reducing post chemotherapy-induced OM [9]. "
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    ABSTRACT: This study was designed to determine the effect of Calendula officinalis flowers extract mouthwash as oral gel on radiation-induced oropharyngeal mucositis (OM) in patients with head-and-neck cancer. Forty patients with neck and head cancers under radiotherapy or concurrent chemoradiotherapy protocols were randomly assigned to receive either 2% calendula extract mouthwash or placebo (20 patients in each group). Patients were treated with telecobalt radiotherapy at conventional fractionation (200 cGy/fraction, five fractions weekly, 30--35 fractions within 4--7 weeks). The oropharyngeal mucositis was evaluated by two clinical investigators (a radiation oncologist and a dentist), using the oral mucositis assessment scale (OMAS). Trying to find out the possible mechanism of action of the treatment, total antioxidant, polyphenol and flavonoid contents, and quercetin concentration of the mouth wash were measured. Calendula mouthwash significantly decreased the intensity of OM compared to placebo at week 2 (score: 5.5 vs. 6.8, p = 0.019), week 3 (score: 8.25 vs. 10.95, p < 0.0001) and week 6 (score: 11.4 vs. 13.35, p = 0.031). Total antioxidant, polyphenol and flavonoid contents and quercetin concentration of the 2% extract were 2353.4 +/- 56.5 muM, 313.40 +/- 6.52 mg/g, 76.66 +/- 23.24 mg/g, and 19.41 +/- 4.34 mg/l, respectively. Calendula extract gel could be effective on decreasing the intensity of radiotherapy- induced OM during the treatment and antioxidant capacity may be partly responsible for the effect.
    Full-text · Article · Mar 2013 · DARU-JOURNAL OF FACULTY OF PHARMACY
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