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.

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.

• Authors: Noam Yarom, Allan Hovan, Paolo Bossi, Anura Ariyawardana, Siri Beier Jensen, Margherita Gobbo, Hanan Saca-Hazboun, Abhishek Kandwal, Alessandra Majorana, Giulia Ottaviani, Monica Pentenero, Narmin Mohammed Nasr, Tanya Rouleau, Anna Skripnik Lucas, Nathaniel Simon Treister, Eyal Zur, Vinisha Ranna, Anusha Vaddi, Andrei Barasch, Rajesh V Lalla, Karis Kin Fong Cheng, Sharon Elad, Mucositis Study Group of the Multinational Association of Supportive Care in Cancer / International Society of Oral Oncology (MASCC/ISOO)
• Journal: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (Support Care Cancer) Vol. 28 Issue 5 Pg. 2457-2472 (May 2020) ISSN: 1433-7339 [Electronic] Germany
• PMID: 32056010 (Publication Type: Journal Article, Systematic Review)

Chemical References

• Antineoplastic Agents
• Central Nervous System Stimulants
• Chewing Gum

Topics

• Antineoplastic Agents (adverse effects, therapeutic use)
• Central Nervous System Stimulants (therapeutic use)
• Chewing Gum
• Head and Neck Neoplasms (drug therapy)
• Honey
• Humans
• Mucositis (drug therapy)
• Plants, Medicinal
• Probiotics (therapeutic use)
• Saliva (drug effects, metabolism)
• Stomatitis (drug therapy)