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Honey Against Radiation-induced Oral Mucositis in Head and Neck Cancer Patients. An Umbrella Review of Systematic Reviews and Meta- Analyses of the Literature

[ Vol. 15 , Issue. 4 ]


Areti Gkantaifi*, Filippo Alongi, Emmanouil Vardas, Francesco Cuccia, Jiannis Hajiioannou, Efthymios Kyrodimos, Christos Christopoulos, Davide Mauri, Nikolaos Charalampakis, Nikolaos Trogkanis, Nikolaos Tsoukalas, George Iliadis and Maria Tolia   Pages 360 - 369 ( 10 )


Backround: Oral mucositis (OM) consists of a major side effect of radiotherapy (RT) in head and neck (H-N) cancer patients and natural honey is gaining more and more scientific interest due to its beneficial effects in tissue repair.

Objective: The aim of this review is to better clarify the preventive/therapeutic role of honey in the management of OM in patients with H-N cancer undergoing RT with or without chemotherapy (CT).

Methods: We used the PubMed database to retrieve journal articles and the inclusion criteria were only reviews and meta-analyses that illustrated the effective use of honey for either the prevention or treatment of OM in H-N cancer patients receiving either RT alone or in combination with CT.

Results: Our search resulted in 92 citations, of which 12 eventually fulfilled the inclusion criteria of our study. Decreased incidence and severity of OM, extended time of occurrence of mucositis, less weight loss and less treatment interruptions were occasionally documented with conventional honey use in the included reviews and meta-analyses. In contrast to conventional honey, manuka honey proved to be weak in improving OM management in the small number of included reviews in our search.

Conclusion: Conventional honey might constitute a highly promising natural product against OM attracting much scientific interest due to its easy accessibility and low financial cost. Hence, the lack of studies with high evidence requires further advanced research to enhance the existing knowledge about the potential value of honey in radiation-induced OM in H-N cancer patients.


Oral mucositis, honey, radiotherapy, head and neck cancer, prevention, treatment.


Radiotherapy Department, Interbalkan Medical Center, 10 Asclepioustr, 55535Pylaia, Thessaloniki, Advanced Radiation Oncology Department, IRCCS SacroCuore Don Calabria,Negrar-Verona, Clinic of Dentistry Hospital, Dental School, National and Kapodistrian University of Athens, 2 Thivonstr, Goudi, 11527Athens, Advanced Radiation Oncology Department, IRCCS SacroCuore Don Calabria,Negrar-Verona, Department of Otolaryngology, Faculty of Medicine, School of Health Sciences, University of Thessaly, University Hospital of Larissa, Biopolis,41110, Larissa, First Department of Otorhinolaryngology, Head and Neck Surgery, Hippocration Hospital, University of Athens, Athens, Radiation Oncology Department, GroupeHospitalierIntercommunal Le Raincy, Montfermeil, 10 Rue du GeneralLeclerc, 93370 Montfermeil, Medical Oncology, University of Ioannina, Ioannina, Oncology Clinic, Metaxa Hospital, Mpotasi 51, 18537Piraeus, National and Kapodistrian University of Athens, Medical School, 2nd Department of Radiology, Radiotherapy Unit, Attikon University Hospital, Athens, Oncology Department, General Military Hospital 401, 138 Mesogeion & Katechaki Avenue, 11525, Athens, Radiotherapy Department, Interbalkan Medical Center, 10 Asclepioustr, 55535Pylaia, Thessaloniki, Department of Radiotherapy, Faculty of Medicine, University of Thessaly, School of Health Sciences, Biopolis,41110, Larisa

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