Effects of various treatments for preventing oral mucositis in cancer patients: A network meta-analysis

PLoS One. 2022 Dec 8;17(12):e0278102. doi: 10.1371/journal.pone.0278102. eCollection 2022.

Abstract

Background: Oral mucositis (OM) is a common side effect of chemotherapy and radiotherapy in patients with cancers. The prevention or treatment of OM in cancer patients is crucial in the treatment of cancer.

Methods: We searched PubMed, Embase, and Cochrane Library for the randomized control trials (RCTs) of interventions for preventing and treating OM. Network meta-analysis (NMA) was performed to estimate odds ratios (ORs) and 95% confidence intervals (CI) from both direct and indirect evidence. The prespecified primary efficacy outcome was the treatment effect of moderate to severe oral mucositis with 12 interventions. The outcome was moderate to a severe grade of OM.

Results: This study included 55 RCTs with 3,552 participants. The results showed that honey significantly lowered the risk of chemo/radiotherapy-induced moderate to severe oral mucositis than placebo (OR: 0.01, 95%CI 0.00 to 0.45), followed by lignocaine (OR: 0.07, 95%CI 0.00 to 0.95). The surface under cumulative ranking curve (SUCRA) values for honey were 0.95, followed by lignocaine (SUCRA, 0.81) and benzydamine (SUCRA, 0.78).

Conclusions: The honey is effective for patients with cancer undergoing chemotherapy or radiotherapy-induced oral mucositis.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Humans
  • Neoplasms* / complications
  • Neoplasms* / drug therapy
  • Neoplasms* / radiotherapy
  • Network Meta-Analysis
  • Stomatitis* / etiology
  • Stomatitis* / prevention & control

Grants and funding

This study was supported by grants from the Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation [TCRD-TPE- 111-53 & TCRD-TPE- 111-54]. The funders had no role in study design, data collection, and analysis, decision to publish, or preparation of the manuscript.