Prophylactic and therapeutic effects of honey on radiochemotherapy-induced mucositis: a meta-analysis of randomized controlled trials

  • Tzu-Ming Liu
  • Yu-Wei Luo
  • Ka-Wai Tam
  • Chia-Chin Lin
  • Tsai-Wei HuangEmail author
Review Article



Oral mucositis is a common side effect of radiochemotherapy and may adversely affect the patients’ quality of life (QoL). Honey application may reduce the mucositis grade in patients. Here, we conducted a meta-analysis of randomized controlled trials (RCTs) to evaluate the prophylactic and therapeutic effects of honey on radiochemotherapy-induced oral mucositis.


Publications on RCTs were extracted from the PubMed, Embase, CINAHL, and Cochrane Library databases. The primary outcomes were mucositis grades and pain scores. Secondary outcomes were the recovery time and QoL. The study was registered with PROSPERO (number CRD42018108486).


Nineteen RCTs, involving 1276 patients, were reviewed. Honey considerably mitigated oral mucositis in both prophylactic and therapeutic phases. In the prophylactic phase, intolerable mucositis development was significantly prevented in the honey-treated group (RR = 0.18, 95% confidence interval [CI] = 0.09 to 0.41). Patients treated with honey showed significant decrease in pain scores in the first month of treatment (weighted mean difference [WMD] = − 3.25, 95% CI = − 4.41 to − 2.09) and at the end of the treatment (WMD = − 2.32, 95% CI = − 4.47 to − 0.18).


Honey, which is relatively cheap and easily available, prevented mucositis and effectively mitigate mucositis in patients after radiochemotherapy. Moreover, it significantly reduced the mucositis grade and engendered a fast and painless healing process. Therefore, honey use during and after radiochemotherapy is recommended for mucositis prevention and treatment.


Honey Mucositis Radiotherapy Chemotherapy Meta-analysis 



This study was funded by Taipei Medical University of Taiwan (grant number TMU106-AE1-B13).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Supplementary material

520_2019_4722_MOESM1_ESM.docx (72 kb)
ESM 1 (DOCX 72 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of Medicine, College of MedicineTaipei Medical UniversityTaipeiTaiwan
  2. 2.Center for Evidence-Based Health CareShuang Ho Hospital, Taipei Medical UniversityNew Taipei CityTaiwan
  3. 3.Department of Medical ResearchShuang Ho Hospital, Taipei Medical UniversityNew Taipei CityTaiwan
  4. 4.Division of General Surgery, Department of Surgery, School of Medicine, College of MedicineTaipei Medical UniversityTaipeiTaiwan
  5. 5.Division of General Surgery, Department of SurgeryShuang Ho Hospital, Taipei Medical UniversityNew Taipei CityTaiwan
  6. 6.Cochrane TaiwanTaipei Medical UniversityTaipeiTaiwan
  7. 7.School of Nursing, College of NursingTaipei Medical UniversityTaipeiTaiwan
  8. 8.School of Nursing, Li Ka Shing Faculty of MedicineThe University of Hong KongPokfulamHong Kong
  9. 9.Alice Ho Miu Ling Nethersole Charity FoundationTai PoHong Kong

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