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

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisReviewForskningpeer review


  • Noam Yarom, Chaim Sheba Medical Center Israel, Tel Aviv University, Israel
  • Allan Hovan, British Columbia Cancer - Vancouver Centre, Canada, Canada
  • Paolo Bossi, University of Brescia, Italy, Italien
  • Anura Ariyawardana, James Cook University, Australia, Metro South Oral Health, Queensland Health, Brisbane, Australia, Australien
  • Siri Beier Jensen
  • Margherita Gobbo, University of Trieste, Italy, Italien
  • Hanan Saca-Hazboun, Al-Maha Cancer Foundation, Bethlehem, Palestine
  • ,
  • Abhishek Kandwal, Himalayan Institute of Medical Sciences, India, Indien
  • Alessandra Majorana, University of Brescia, Italy, Italien
  • Giulia Ottaviani, University of Trieste, Italy, Italien
  • Monica Pentenero, Università degli Studi di Torino, Italien
  • Narmin Mohammed Nasr, Ministry of Health Oman
  • ,
  • Tanya Rouleau, North East Cancer Center, Canada, Canada
  • Anna Skripnik Lucas, Department of Medicine, NYU Langone Perlmutter Cancer Center, New York, USA, USA
  • Nathaniel Simon Treister, Brigham and Women’s Hospital, Boston, MA, USA, Harvard School of Dental Medicine Department of Oral Medicine, Infection and Immunity, Boston, MA, USA, USA
  • Eyal Zur, Compounding Solutions, Tel-Mond, Israel, Israel
  • Vinisha Ranna, The Mount Sinai Hospital Department of Oral and Maxillofacial Surgery New York 10029, USA, USA
  • Anusha Vaddi, University of Rochester Medical Center Oral Medicine, Eastman Institute for Oral Health Rochester, New York, USA, University of Connecticut, USA
  • Andrei Barasch, Harvard University, USA
  • Rajesh V. Lalla, University of Connecticut, USA
  • Karis Kin Fong Cheng, National University of Singapore, Singapore
  • Sharon Elad, University of Rochester, USA
  • On behalf of The Mucositis Study Group of the Multinational Association of Supportive Care in Cancer / International Society of Oral Oncology (MASCC/ISOO)

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.

TidsskriftSupportive Care in Cancer
Sider (fra-til)2457-2472
Antal sider16
StatusUdgivet - maj 2020

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