Skip to main content
Erschienen in: Supportive Care in Cancer 12/2018

19.07.2018 | Review Article

Meta-analysis of randomized controlled trials of the efficacy of propolis mouthwash in cancer therapy-induced oral mucositis

verfasst von: Chen-Chen Kuo, Ruey-Hsia Wang, PhD, Hsiu-Hung Wang, PhD, Chun-Hua Li

Erschienen in: Supportive Care in Cancer | Ausgabe 12/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

This meta-analysis aimed to evaluate the efficacy and safety of propolis mouthwash in cancer patients with therapy-induced oral mucositis.

Methods

This was a systematic review of randomized control trails (RCTs). We searched ten electronic databases for studies published prior to April 06, 2017. The included RCTs were published in English and Chinese. The Jadad score was used to evaluate the quality of the articles identified. Two reviewers independently evaluated each of the studies. The data were entered into Review Manager (RevMan) 5.3 software and checked for accuracy. Outcome incidence analysis was performed using odds ratios (ORs).

Results

Of the 352 articles identified, five potentially relevant articles met our inclusion criteria. These 5 RCTs included a total of 209 participants. The Jadad score for methodological quality was 3.60 ± 0.55. No obvious publication bias was noted. The incidence of severe oral mucositis was significantly lower in the propolis group than in the control group (OR = 0.35, p = 0. 003). The corresponding 95% confidence interval (CI) was 0.18 to 0.70. Between-study heterogeneity was low (I2 = 0.000, p = 0.45). No side effects were reported.

Conclusions

Propolis mouthwash is effective and safe in the treatment of severe oral mucositis. To maintain propolis safety, propolis usage should occur under the supervision of medical staff and health professionals. Future multi-center studies and a clinical protocol are needed to confirm the current findings regarding the efficacy and safety of propolis mouthwash.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Al Ibraheemi AA, Shamoun S (2016) Incidence and risk factors of oral mucositis in patients with breast cancer who receiving chemotherapy in Al-Bashir hospital. Int J Hematol Oncol Stem Cell Res 10(4):217–223 Al Ibraheemi AA, Shamoun S (2016) Incidence and risk factors of oral mucositis in patients with breast cancer who receiving chemotherapy in Al-Bashir hospital. Int J Hematol Oncol Stem Cell Res 10(4):217–223
2.
Zurück zum Zitat Mallick S, Benson R, Rath GK (2016) Radiation induced oral mucositis: a review of current literature on prevention and management. Eur Arch Otorhinolaryngol 273(9):2285–2293CrossRef Mallick S, Benson R, Rath GK (2016) Radiation induced oral mucositis: a review of current literature on prevention and management. Eur Arch Otorhinolaryngol 273(9):2285–2293CrossRef
3.
Zurück zum Zitat Stokman MA, Spijkervet FK, Boezen HM, Schouten JP, Roodenburg JL, de Vries EG (2006) Preventive intervention possibilities in radiotherapy- and chemotherapy-induced oral mucositis: results of meta-analyses. J Dent Res 85(5):690–700CrossRef Stokman MA, Spijkervet FK, Boezen HM, Schouten JP, Roodenburg JL, de Vries EG (2006) Preventive intervention possibilities in radiotherapy- and chemotherapy-induced oral mucositis: results of meta-analyses. J Dent Res 85(5):690–700CrossRef
4.
Zurück zum Zitat Trotti A, Bellm LA, Epstein JB, Frame D, Fuchs HJ, Gwede CK, Komaroff E, Nalysnyk L, Zilberberg MD (2003) Mucositis incidence, severity and associated outcomes in patients with head and neck cancer receiving radiotherapy with or without chemotherapy: a systematic literature review. Radiother Oncol 66(3):253–262CrossRef Trotti A, Bellm LA, Epstein JB, Frame D, Fuchs HJ, Gwede CK, Komaroff E, Nalysnyk L, Zilberberg MD (2003) Mucositis incidence, severity and associated outcomes in patients with head and neck cancer receiving radiotherapy with or without chemotherapy: a systematic literature review. Radiother Oncol 66(3):253–262CrossRef
5.
Zurück zum Zitat Al Jaouni SK, Al Muhayawi MS, Hussein A, Elfiki I, Al-Raddadi R, Al Muhayawi SM, Almasaudi S, Kamal MA, Harakeh S (2017) Effects of honey on oral mucositis among pediatric cancer participants undergoing chemo/radiotherapy treatment at King Abdulaziz university hospital in Jeddah, Kingdom of Saudi Arabia. Evid Based Complement Alternat Med 2017:5861024.https://www.hindawi.com/journals/ecam/2017/5861024/. Accessed 5 March 2017CrossRef Al Jaouni SK, Al Muhayawi MS, Hussein A, Elfiki I, Al-Raddadi R, Al Muhayawi SM, Almasaudi S, Kamal MA, Harakeh S (2017) Effects of honey on oral mucositis among pediatric cancer participants undergoing chemo/radiotherapy treatment at King Abdulaziz university hospital in Jeddah, Kingdom of Saudi Arabia. Evid Based Complement Alternat Med 2017:5861024.https://​www.​hindawi.​com/​journals/​ecam/​2017/​5861024/​. Accessed 5 March 2017CrossRef
6.
Zurück zum Zitat Eslami H, Pouralibaba F, Falsafi P, Bohluli S, Najati B, Negahdari R, Ghanizadeh M (2016) Efficacy of Hypozalix spray and propolis mouthwash for prevention of chemotherapy-induced oral mucositis in leukemic patients: a double-blind randomized clinical trial. J Dent Res Dent Clin Dent Prospects 10(4):226–233CrossRef Eslami H, Pouralibaba F, Falsafi P, Bohluli S, Najati B, Negahdari R, Ghanizadeh M (2016) Efficacy of Hypozalix spray and propolis mouthwash for prevention of chemotherapy-induced oral mucositis in leukemic patients: a double-blind randomized clinical trial. J Dent Res Dent Clin Dent Prospects 10(4):226–233CrossRef
7.
Zurück zum Zitat Tomaževič T, Jazbec J (2013) A double blind randomised placebo controlled study of propolis (bee glue) effectiveness in the treatment of severe oral mucositis in chemotherapy treated children. Complement Ther Med 21(4):306–312CrossRef Tomaževič T, Jazbec J (2013) A double blind randomised placebo controlled study of propolis (bee glue) effectiveness in the treatment of severe oral mucositis in chemotherapy treated children. Complement Ther Med 21(4):306–312CrossRef
8.
Zurück zum Zitat Elting LS, Cooksley C, Chambers M, Cantor SB, Manzullo E, Rubenstein EB (2003) The burdens of cancer therapy. Clinical and economic outcomes of chemotherapy-induced mucositis. Cancer 98(7):1531–1539CrossRef Elting LS, Cooksley C, Chambers M, Cantor SB, Manzullo E, Rubenstein EB (2003) The burdens of cancer therapy. Clinical and economic outcomes of chemotherapy-induced mucositis. Cancer 98(7):1531–1539CrossRef
9.
Zurück zum Zitat Lalla RV, Sonis ST, Peterson DE (2008) Management of oral mucositis in patients who have cancer. Dent Clin North Am 52(1):61–77CrossRef Lalla RV, Sonis ST, Peterson DE (2008) Management of oral mucositis in patients who have cancer. Dent Clin North Am 52(1):61–77CrossRef
10.
Zurück zum Zitat Worthington HV, Clarkson JE, Bryan G, Furness S, Glenny AM, Littlewood A, McCabe MG, Meyer S, Khalid T (2011) Interventions for preventing oral mucositis in patients with cancer receiving treatment. Cochrane database Syst Rev 13(4):CD000978 Worthington HV, Clarkson JE, Bryan G, Furness S, Glenny AM, Littlewood A, McCabe MG, Meyer S, Khalid T (2011) Interventions for preventing oral mucositis in patients with cancer receiving treatment. Cochrane database Syst Rev 13(4):CD000978
11.
Zurück zum Zitat Raeessi MA, Raeessi N, Panahi Y, Gharaie H, Davoudi SM, Saadat A, Karimi Zarchi AA, Raeessi F, Ahmadi SM, Jalalian H (2014) “Coffee plus honey” versus “topical steroid” in the treatment of chemotherapy-induced oral mucositis: a randomised controlled trial. BMC Complement Altern Med 14:293 Raeessi MA, Raeessi N, Panahi Y, Gharaie H, Davoudi SM, Saadat A, Karimi Zarchi AA, Raeessi F, Ahmadi SM, Jalalian H (2014) “Coffee plus honey” versus “topical steroid” in the treatment of chemotherapy-induced oral mucositis: a randomised controlled trial. BMC Complement Altern Med 14:293
15.
Zurück zum Zitat Noronha VR, Araujo GS, Gomes RT, Iwanaga SH, Barbosa MC, Abdo EN, Ferreira e Ferreira E, Viana Campos AC, Souza AA, Abreu SR, Santos VR (2014) Mucoadhesive propolis gel for prevention of radiation-induced oral mucositis. Curr Clin Pharmacol 9(4):359–364CrossRef Noronha VR, Araujo GS, Gomes RT, Iwanaga SH, Barbosa MC, Abdo EN, Ferreira e Ferreira E, Viana Campos AC, Souza AA, Abreu SR, Santos VR (2014) Mucoadhesive propolis gel for prevention of radiation-induced oral mucositis. Curr Clin Pharmacol 9(4):359–364CrossRef
17.
Zurück zum Zitat Yildiz OG, Soyuer S, Saraymen R, Eroglu C (2008) Protective effects of caffeic acid phenethyl ester on radiation induced lung injury in rats. Clin Invest Med 31(15):E242–E247CrossRef Yildiz OG, Soyuer S, Saraymen R, Eroglu C (2008) Protective effects of caffeic acid phenethyl ester on radiation induced lung injury in rats. Clin Invest Med 31(15):E242–E247CrossRef
18.
Zurück zum Zitat Pappalardo G, Siegrist HH, Francioli P (1991) Evaluation of a new antiseptic based on natural substances. Drugs Exp Clin Res 17(10-11):531–535 Pappalardo G, Siegrist HH, Francioli P (1991) Evaluation of a new antiseptic based on natural substances. Drugs Exp Clin Res 17(10-11):531–535
19.
Zurück zum Zitat Magro-Filho O, de Carvalho AC (1994) Topical effect of propolis in the repair of sulcoplasties by the modified Kazanjian technique. Cytological and clinical evaluation. J Nihon Univ Sch Dent 36:102–111CrossRef Magro-Filho O, de Carvalho AC (1994) Topical effect of propolis in the repair of sulcoplasties by the modified Kazanjian technique. Cytological and clinical evaluation. J Nihon Univ Sch Dent 36:102–111CrossRef
24.
Zurück zum Zitat Food standards (Australia New Zealand food standards code) (2002) New Zealand (bee product warning statements - dietary supplements) Food Standards 2002. New Zealand food safety authority Publishing Food standards Web. File:///C:/users/user/downloads/nz-bee-product-warning-statements-dietary-supplements-food-standards-2002%20(2).Pdf. Accessed 27 April 2018 Food standards (Australia New Zealand food standards code) (2002) New Zealand (bee product warning statements - dietary supplements) Food Standards 2002. New Zealand food safety authority Publishing Food standards Web. File:///C:/users/user/downloads/nz-bee-product-warning-statements-dietary-supplements-food-standards-2002%20(2).Pdf. Accessed 27 April 2018
25.
Zurück zum Zitat Lalla RV, Bowen J, Barasch A, Elting L, Epstein J, Keefe DM, McGuire DB, Migliorati C, Nicolatou-Galitis O, Peterson DE, Raber-Durlacher JE, Sonis ST, Elad S, Mucositis Guidelines Leadership Group of the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) (2014) MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer 120(10):1453–1461CrossRef Lalla RV, Bowen J, Barasch A, Elting L, Epstein J, Keefe DM, McGuire DB, Migliorati C, Nicolatou-Galitis O, Peterson DE, Raber-Durlacher JE, Sonis ST, Elad S, Mucositis Guidelines Leadership Group of the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) (2014) MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer 120(10):1453–1461CrossRef
26.
Zurück zum Zitat Hwu YJ, Lin FY (2014) Effectiveness of propolis on oral health: a meta-analysis. J Nurs Res 22:221–229CrossRef Hwu YJ, Lin FY (2014) Effectiveness of propolis on oral health: a meta-analysis. J Nurs Res 22:221–229CrossRef
27.
Zurück zum Zitat Chen Y, Wong RW, McGrath C, Hagg U, Seneviratne CJ (2014) Natural compounds containing mouthrinses in the management of dental plaque and gingivitis: a systematic review. Clin Oral Investig 18(1):1–16CrossRef Chen Y, Wong RW, McGrath C, Hagg U, Seneviratne CJ (2014) Natural compounds containing mouthrinses in the management of dental plaque and gingivitis: a systematic review. Clin Oral Investig 18(1):1–16CrossRef
28.
Zurück zum Zitat Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group (2010) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg 8(5):336–341CrossRef Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group (2010) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg 8(5):336–341CrossRef
29.
Zurück zum Zitat Liu L, Moody J, Gall A (2016) A quantitative, pooled analysis and systematic review of controlled trials on the impact of electrical stimulation settings and placement on pressure ulcer healing rates in persons with spinal cord injuries. Ostomy Wound Manag 62(7):16–34 Liu L, Moody J, Gall A (2016) A quantitative, pooled analysis and systematic review of controlled trials on the impact of electrical stimulation settings and placement on pressure ulcer healing rates in persons with spinal cord injuries. Ostomy Wound Manag 62(7):16–34
30.
Zurück zum Zitat Hassan WM, Mehanna M, Nour R, Yehia D, Atta N, Alfaar AS (2015) Association between quality of clinical trials and human development index in heart failure using JADAD scale. Princ Pract Clin Res 1(2):40–46 Hassan WM, Mehanna M, Nour R, Yehia D, Atta N, Alfaar AS (2015) Association between quality of clinical trials and human development index in heart failure using JADAD scale. Princ Pract Clin Res 1(2):40–46
32.
Zurück zum Zitat Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629–634CrossRef Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629–634CrossRef
33.
Zurück zum Zitat Sterne JA, Sutton AJ, Ioannidis JP, Terrin N, Jones DR, Lau J, Carpenter J, Rücker G, Harbord RM, Schmid CH, Tetzlaff J, Deeks JJ, Peters J, Macaskill P, Schwarzer G, Duval S, Altman DG, Moher D, Higgins JP (2011) Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomized controlled trials. BMJ 343:d4002. https://www.bmj.com/content/bmj/343/bmj.d4002.full.pdf. Accessed 2 May 2018CrossRef Sterne JA, Sutton AJ, Ioannidis JP, Terrin N, Jones DR, Lau J, Carpenter J, Rücker G, Harbord RM, Schmid CH, Tetzlaff J, Deeks JJ, Peters J, Macaskill P, Schwarzer G, Duval S, Altman DG, Moher D, Higgins JP (2011) Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomized controlled trials. BMJ 343:d4002. https://​www.​bmj.​com/​content/​bmj/​343/​bmj.​d4002.​full.​pdf. Accessed 2 May 2018CrossRef
34.
Zurück zum Zitat Bae JH, Kim YK, Myung SK (2011) Effects of platelet-rich plasma on sinus bone graft: meta-analysis. J Periodontol 82(5):660–667CrossRef Bae JH, Kim YK, Myung SK (2011) Effects of platelet-rich plasma on sinus bone graft: meta-analysis. J Periodontol 82(5):660–667CrossRef
35.
Zurück zum Zitat Liu LQ, Moody J, Traynor M, Dyson S, Gall A (2014) A systematic review of electrical stimulation for pressure ulcer prevention and treatment in people with spinal cord injuries. J Spinal Cord Med 37(6):703–718CrossRef Liu LQ, Moody J, Traynor M, Dyson S, Gall A (2014) A systematic review of electrical stimulation for pressure ulcer prevention and treatment in people with spinal cord injuries. J Spinal Cord Med 37(6):703–718CrossRef
36.
Zurück zum Zitat Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327(7414):557–560CrossRef Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327(7414):557–560CrossRef
38.
Zurück zum Zitat AkhavanKarbassi MH, Yazdi MF, Ahadian H, SadrAbad MJ (2016) Randomized double blind placebo controlled trial of propolis for oral ,ucositis in patients receiving chemotherapy for head and neck cancer. Asian Pac J Cancer Prev 17(7):3611–3614 AkhavanKarbassi MH, Yazdi MF, Ahadian H, SadrAbad MJ (2016) Randomized double blind placebo controlled trial of propolis for oral ,ucositis in patients receiving chemotherapy for head and neck cancer. Asian Pac J Cancer Prev 17(7):3611–3614
39.
Zurück zum Zitat Kai-Lin Tang, Chia-Chin Lin (2016) Effects of propolis oral care intervention on improving the oral status in lung cancer patients receiving chemotherapy. New Taipei Journal of Nursing 18(1):31–43 Kai-Lin Tang, Chia-Chin Lin (2016) Effects of propolis oral care intervention on improving the oral status in lung cancer patients receiving chemotherapy. New Taipei Journal of Nursing 18(1):31–43
40.
Zurück zum Zitat Miguel MG, Antunes MD (2011) Is propolis safe as an alternative medicine? J Pharm Bioallied Sci 3(4):479–495CrossRef Miguel MG, Antunes MD (2011) Is propolis safe as an alternative medicine? J Pharm Bioallied Sci 3(4):479–495CrossRef
Metadaten
Titel
Meta-analysis of randomized controlled trials of the efficacy of propolis mouthwash in cancer therapy-induced oral mucositis
verfasst von
Chen-Chen Kuo
Ruey-Hsia Wang, PhD
Hsiu-Hung Wang, PhD
Chun-Hua Li
Publikationsdatum
19.07.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Supportive Care in Cancer / Ausgabe 12/2018
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-018-4344-5

Weitere Artikel der Ausgabe 12/2018

Supportive Care in Cancer 12/2018 Zur Ausgabe

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.