title: Effects of honey on oral mucositis in patients with head and neck cancer: A meta-analysis.
abstract: OBJECTIVE
  The objective of this study was to perform a meta-analysis of the efficacy of honey in the management of oral mucositis during radiotherapy in patients with head and neck cancer.
  
  
  METHODS
  Meta-analysis using MEDLINE, Scopus, and the Cochrane Library as data sources.
  
  
  METHODS
  Two authors independently searched the databases for relevant studies from inception to June 2014. Included in the meta-analysis were randomized controlled studies published in English comparing the oral administration of honey (honey group) with placebo or no treatment (control group) in patients with head and neck cancer who were undergoing radiotherapy or chemoradiotherapy. Excluded studies failed to report quantifiable outcome measures regarding oral mucositis. Outcomes of interest included the degree and incidence of mucositis, incidence of microbial colonization, and weight loss.
  
  
  RESULTS
  Nine studies comprising 476 patients were included in the meta-analysis. The incidence of moderate to severe mucositis and the mean mucositis grade during the first 3 weeks of therapy were significantly lower in the honey group than the control group. Additionally, the onset of mucositis was significantly later in the honey group than the control. Although there were no significant differences in the incidences of microbial colonization and pain experienced between the two groups, the incidence of weight loss was significantly lower in the honey group than control group.
  
  
  CONCLUSIONS
  Oral administration of honey after radiotherapy could prevent moderate to severe mucositis and associated weight loss. However, because our results were based on an analysis of a small number of trials, further trials are required to confirm these results.
  
  
  METHODS
  NA.
authors.affiliation: Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Hye Kyung
authors.initials: HK
authors.lastname: Cho
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Yeon Min
authors.initials: YM
authors.lastname: Jeong
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Ho Seok
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Yeon Ji
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Se Hwan
authors.initials: SH
authors.lastname: Hwang
mesh_terms: D059248:Chemoradiotherapy / Q000009:adverse effects; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006722:Honey; D006801:Humans; D009061:Mouth Mucosa / Q000187:drug effects / Q000528:radiation effects*; D013280:Stomatitis / Q000209:etiology / Q000628:therapy*
keywords: Head and neck neoplasm; chemoradiotherapy; honey; meta-analysis; mucositis; radiotherapy