June 2003

Dear Readers: Here's the Article for this Month:

Name of article:

Topical application of honey in the management of radiation mucositis. A preliminary study

Author(s): Biswal BM, Zakaria A, Ahmad NM
Reference: Support Care Cancer 2003; 11: 242-8

Abstract: 

The development of oral mucositis is considered to be an inevitable, but very distressing acute side effect of radiation therapy (RT) to the head and neck region. According to the data in the literature at least 50% of patients will experience grade 3 mucositis when 66-70 Gy radiation are delivered to large mucosal surfaces in 6-7 weeks. Whilst the incidence of mucosistis might also be reduced in different ways, the treatment of radiation-induced mucositis is not definitively established.

The Authors carried out the first prospective randomized trial to evaluate the effect of pure natural honey in patients with radiation-induced mucositis. Forty patients undergoing radiotherapy to the head and neck region received either topical application of the honey along with RT or RT alone. Conventional fractionated radiation (by means of a 6-MV linear accelerator) was delivered to the tumor volume at a dose rate of 2 Gy per day, five times a week till a dose of 60-70 Gy. Twenty patients received 20 ml of natural honey before RT, 20 ml after RT and 20 ml 6 hours after RT. These patients had to rinse honey on the oral mucosa and slowly swallow it. The patients received honey throughout the course of RT.

A significant reduction in the symptomatic grade 3/4 mucositis (RTOG grading system) was found in the honey-treated group in respect to controls (20% vs 75% p 0.00058). Fifty-five per cent of the honey-treated patients showed either static or positive weight gain during RT in comparison to 25% in the controls (p<0.05) the majority of whom lost weight. There were neither complications related to pure honey administration nor changes in blood sugar monitoring.

According to the Authors future multicentre randomized trials are necessary to validate their finding.

Why I chose this article.

I choose this article because honey is a natural product, it is available anywhere in the world at a very low cost and it showed to be effective in treating burn wounds, oral infections , infected surgical wounds, eye infections and patients suffering from radiation-induced mucositis. I have also choose this article because the physicians of the Malaysia teach us that is possible to treat our patients in a very simple and above all in a "very sweety "way!!

Regards,

Carla Ripamonti, MD
Member of the Board of Directors, IAHPC