Role of Honey in Prevention of Radiation induced Mucositis in Head and Neck Cancer

Objective: To determine the efficacy of honey in preventing radiation induced mucositis (RIM) in patients with head and neck cancers. Design: Randomized controlled trial. Setting: Oncology Department of Combined Military Hospital Rawalpindi, from July 2011 to September 2012. Patients and Methods: Sixty patients diagnosed with head and neck cancer requiring radiotherapy to the oropharyngeal mucosa were randomized into two groups to receive either radiation alone or radiation and natural honey. Patients were treated using 6-MV X-ray beams from linear accelerator at a dose rate of 2 Gy per day five times a week up to a dose of 66 Gy. In the treatment group, patients were advised to take 20 ml of pure honey 15 minutes before, 15 minutes after and 6 hours after radiotherapy. Patients were evaluated every week for the development of RIM using the WHO oral mucositis grading system. Results: In treatment group, out of 30 patients, 4(13%) developed grade 3 RIM and none developed grade 4 RIM. In control group, out of 30 patients, 12 (40%) developed grade 3 or 4 RIM (p=0.039). Four patients (13%) in treatment group lost more than 5 Kg weight during the course of radiotherapy compared to 16 patients (53%) in control group (p=0.002). Conclusion: The results of our study have shown that honey is a simple and cost effective treatment to prevent RIM. Large scale randomized trials are needed to confirm the results of our study. (author)