Effect of Honey-Lemon Spray Versus Benzydamine Hydrochloride Spray on Radiation-Induced Acute Oral Mucositis in Head and Neck Cancer Patients: A Pilot, Randomized, Double-Blind, Active-Controlled Clinical Trial.

Abstract

Introduction: Oral mucositis (OM) is the most prevalent side effect in patients with head and neck cancer (HNC). It causes an obvious decrease in quality of life (QoL) in these patients, so different medications have been recommended for OM, however, without optimal response. This randomized trial aimed to assess the effects of a honey-lemon spray compared with benzydamine hydrochloride in prevention of radiation-induced OM in patients with HNC. Materials and Methods: Forty-six patients with HNC received external beam radiotherapy for 5 days per week. Patients were randomized to treatment with either benzydamine hydrochloride spray or honey-lemon spray for 5 weeks and continued for 1 week after the end of treatment. The oral cavity was examined weekly, with a score given to each site based on the degree of mucositis using a 4-point scale, and a mean mucositis score was calculated as the primary outcome. Occurrence of OM, pain, QoL, and adverse effects were defined as secondary outcomes. Patients, therapists, and outcome assessors were blinded to group allocation. Results: No significant group differences occurred in the mucositis score, pain, or QoL. Mucositis occurrence rates were higher in the benzydamine hydrochloride group compared with the honey-lemon group (hazard ratio = 2.1, 95% confidence interval: 1.1 to 4.2). Two patients in the honey-lemon group had mild nausea and burning throat; no adverse effects occurred in the benzydamine hydrochloride group. Conclusions: There were no significant group differences in mucositis severity between patients treated with honey-lemon spray and benzydamine hydrochloride. The potential preventive effects of honey-lemon spray need to be confirmed in further trials. The trial registration number is IRCT20161024030467N1.

• Authors: Ahmad Ameri, Sanaz Poshtmahi, Ghazaleh Heydarirad, Holger Cramer, Rasoul Choopani, Homa Hajimehdipoor, Samira Azghandi, Mehdi Pasalar
• Journal: Journal of alternative and complementary medicine (New York, N.Y.) (J Altern Complement Med) Vol. 27 Issue 3 Pg. 255-262 (Mar 2021) ISSN: 1557-7708 [Electronic] United States
• PMID: 33512251 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Aerosols
• Anti-Inflammatory Agents
• Biological Products
• Benzydamine

Topics

• Adult
• Aerosols
• Aged
• Anti-Inflammatory Agents (administration & dosage, therapeutic use)
• Benzydamine (administration & dosage, therapeutic use)
• Biological Products (administration & dosage, therapeutic use)
• Citrus
• Double-Blind Method
• Female
• Head and Neck Neoplasms (radiotherapy)
• Honey
• Humans
• Iran
• Male
• Medicine, Traditional
• Middle Aged
• Pilot Projects
• Radiation Injuries (drug therapy, etiology)
• Radiotherapy (adverse effects)
• Stomatitis (drug therapy, etiology)