377PD A randomized controlled trial evaluating honey for radiation induced mucositis in head & neck cancer patients

Abstract

Aim/Background: Radiation induced mucositis is one of the major cause of morbidity and treatment gaps of head and neck cancer patients receiving concomitant chemoradiation. Apart from imparting additional morbidity and economic burden to patients in the form of requiring parenteral analgesia, interruption of radiation therapy (RT) and/or hospitalization, parenteral or tube feeding, it also has significant negative impact on quality of life. This paper aims to study the role of honey in reducing oral mucositis in head and neck cancer patients receiving concomitant chemoradiation. Methods: A Randomized controlled trial on seventy-eight subjects (forty in test group and thirty-eight in control group) was undertaken to study the effect of honey on oral mucositis, but the analysis of 69 patients was done as 9 patients (4 in test and 5 in control group) lost to follow up or left treatment in between the study. All patients were advised to do salt-soda & benzydamine mouth gargles alternatively every 3 hours. Test group patients additionally received 20 ml honey three times a day during entire course of radiation treatment till 3 months following RT completion. Results: All the patients in both the groups had no mucositis at presentation. As the treatment progressed, test group patients had delayed appearance of mucositis as well as the severity of mucositis was lesser in test group patients. Grade 3 mucositis was documented in 19.4% test group patients while 81.8% and 6% patients in control group had grade 3 and grade 4 mucositis respectively. Thereby patient receiving honey had lesser treatment gaps and significantly lesser mean overall radiotherapy treatment duration. (Mean OTT in test group was 49.61 days verses 53.81 days in control, p < 0.05). Conclusions: Honey being a cheap, palatable and natural medicament can be used for decreasing radiation induced mucositis in cancer patients.