Rashad U M, Al-Gezawy S M, El-Gezawy E, Azzaz A N
Department of Otolaryngology, Oncology, Faculty of Medicine, Assiut University, Egypt.
J Laryngol Otol. 2009 Feb;123(2):223-8. doi: 10.1017/S0022215108002478. Epub 2008 May 19.
To evaluate the efficacy of pure natural honey as prophylaxis against radiochemotherapy-induced mucositis, through clinical scoring of oral and oropharyngeal mucositis, and culturing of pathogenic oral and oropharyngeal microbes.
The study was done in Assiut University Hospital, Egypt, between January 2005 and July 2006. Forty patients diagnosed with head and neck cancer were entered into the trial. Enrolled patients were randomised to either the treatment group, receiving concomitant chemotherapy and radiotherapy (with a significant area of directly visible oral and/or oropharyngeal mucosa included in the radiation fields) plus prior topical application of pure natural honey, or the control group, receiving concomitant chemotherapy and radiotherapy without honey. Patients were evaluated clinically every week to assess development of radiation mucositis. Aerobic cultures and candida colonisation assessment were undertaken, via oral and oropharyngeal swabs, prior to and at the completion of irradiation, and when infection was evident.
In the treatment group, no patients developed grade four mucositis and only three patients (15 per cent) developed grade three mucositis. In the control group, 13 patients (65 per cent) developed grade three or four mucositis (p < 0.05). Candida colonisation was found in 15 per cent of the treatment group and 60 per cent of the control group, either during or after radiotherapy (p = 0.003). Positive cultures for aerobic pathogenic bacteria were observed in 15 per cent of the treatment group and 65 per cent of the control group, during or after radiotherapy (p = 0.007).
This study shows that prophylactic use of pure natural honey was effective in reducing mucositis resulting from radiochemotherapy in patients with head and neck cancer.
通过对口腔和口咽黏膜炎进行临床评分以及对口腔和口咽致病微生物进行培养，评估纯天然蜂蜜预防放化疗引起的黏膜炎的疗效。
该研究于2005年1月至2006年7月在埃及阿斯尤特大学医院进行。40例被诊断为头颈癌的患者进入试验。入选患者被随机分为治疗组，接受同步化疗和放疗（放疗野包括直接可见的大面积口腔和/或口咽黏膜）加放疗前局部应用纯天然蜂蜜，或对照组，接受同步化疗和放疗但不使用蜂蜜。每周对患者进行临床评估以评估放射性黏膜炎的发展情况。在放疗前、放疗结束时以及出现感染迹象时，通过口腔和口咽拭子进行需氧菌培养和念珠菌定植评估。
治疗组中，无患者发生4级黏膜炎，仅3例患者（15%）发生3级黏膜炎。对照组中，13例患者（65%）发生3级或4级黏膜炎（p<0.05）。放疗期间或放疗后，治疗组15%的患者和对照组60%的患者发现念珠菌定植（p=0.003）。放疗期间或放疗后，治疗组15%的患者和对照组65%的患者观察到需氧病原菌培养阳性（p=0.007）。
本研究表明，对头颈癌患者预防性使用纯天然蜂蜜可有效减轻放化疗引起的黏膜炎。
