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. 2020 May;28(5):2457-2472.
doi: 10.1007/s00520-019-05256-4. Epub 2020 Feb 13.

Systematic review of natural and miscellaneous agents, for the management of oral mucositis in cancer patients and clinical practice guidelines - part 2: honey, herbal compounds, saliva stimulants, probiotics, and miscellaneous agents

Noam Yarom  1   2 , Allan Hovan  3 , Paolo Bossi  4 , Anura Ariyawardana  5   6 , Siri Beier Jensen  7 , Margherita Gobbo  8 , Hanan Saca-Hazboun  9 , Abhishek Kandwal  10 , Alessandra Majorana  11 , Giulia Ottaviani  8 , Monica Pentenero  12 , Narmin Mohammed Nasr  13 , Tanya Rouleau  14 , Anna Skripnik Lucas  15 , Nathaniel Simon Treister  16   17 , Eyal Zur  18 , Vinisha Ranna  19 , Anusha Vaddi  20   21 , Andrei Barasch  22 , Rajesh V Lalla  21 , Karis Kin Fong Cheng  23 , Sharon Elad  20 ; Mucositis Study Group of the Multinational Association of Supportive Care in Cancer / International Society of Oral Oncology (MASCC/ISOO)
Affiliations

Systematic review of natural and miscellaneous agents, for the management of oral mucositis in cancer patients and clinical practice guidelines - part 2: honey, herbal compounds, saliva stimulants, probiotics, and miscellaneous agents

Noam Yarom et al. Support Care Cancer. 2020 May.

Abstract

Objective: To update the clinical practice guidelines for the management of oral mucositis (OM) that were developed by the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). This part focuses on honey, herbal compounds, saliva stimulants, probiotics, and miscellaneous agents.

Methods: A systematic review was conducted by the Mucositis Study Group of MASCC/ISOO. The body of evidence for each intervention, in each clinical setting, was assigned an evidence level. The findings were added to the database used to develop the 2014 MASCC/ISOO clinical practice guidelines. Based on the evidence level, one of the following guidelines were determined: Recommendation, Suggestion, No Guideline Possible.

Results: A total of 78 papers were identified within the scope of this section, of which 49 were included in this review and merged with nine publications that were reported in the previous guidelines update. A new Suggestion was made for honey (combined topical and systemic delivery) for the prevention of OM in head and neck cancer patients receiving radiotherapy with or without chemotherapy. A new Suggestion clarified that chewing gum is not effective for the prevention of OM in pediatric patients with hematological or solid cancer treated with chemotherapy. No guideline was possible for other interventions.

Conclusions: Numerous natural products and herbal remedies were studied for the management of OM. Of the agents reviewed in this systematic review, a guideline in favor was made for honey (combined topical and systemic), while a guideline against was made for chewing gum. Additional research is warranted to clarify the potential of other interventions.

Keywords: Cancer; Complementary; Herbal; Management; Natural; Oral mucositis; Traditional.

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