Preventing and Therapeutic Effect of Propolis in Radiotherapy Induced Mucositis of Head and Neck Cancers: A Triple-Blind, Randomized, Placebo-Controlled Trial

Abstract

Background:Mucositis is one of the acute complications of radiotherapy which can ulcerate oral mucosa and cause severe pain and discomfort which can affect oral normal function. Propolis is a natural source of flavenoid which has antiulcer, antibacterial, antifungal, healing and anti-inflammatory effects. Using such an affordable compound without any bad smell or taste that has reasonable price can help the radiotherapy undergoing patients.Objectives:Our goal is assessing the preventing and therapeutic effect of propolis in radiotherapy induced mucositis in patients with head and neck cancer.Patients and Methods:In a randomized triple blind clinical trial, 20 patient were selected randomly to swish and swallow 15 ml of water based extract of propolis mouth wash 3 times a day in the case group (n = 10) and 15 ml placebo mouth wash in control group (n = 10). we use NIC-CTC scale for determining mucositis grading.Results:We use T-test, Man-Whitney, Chi-square, and Friedman as analyzing tests. Case group had significantly (P < 0.05) lower grade of mucositis in all of the follow-ups, but xerostomia is not significantly different in two groups (P > 0.05).Conclusions:This is a pilot study which shows water based extract of propolis efficiently prevents and heals radiotherapy induced mucositis.

The Influence of Toothpaste Containing Australian Melaleuca alternifolia Oil and Ethanolic Extract of Polish Propolis on Oral Hygiene and Microbiome in Patients Requiring Conservative Procedures

“…There are also reports claiming that propolis reduces oral mucositis in patients undergoing radiotherapy. Research conducted by Javadzadeh Balouri et al confirmed that propolis prevents and is efficient in treating radiotherapy-induced mucositis [ 34 ]. Another significant activity of propolis is its antiviral effect.…”

Natural Product Interventions for Chemotherapy and Radiotherapy-Induced Side Effects

“…Propolis is a natural product collected by honeybee worker, and contains flavonoids with anti-ulcer, anti-bacterial, anti-fungal, healing and anti-inflammatory effects (Dodwad and Kukreja, 2011 ). Its water extract mouthwash efficiently prevents and heals chemotherapy or radiotherapy-induced oral mucositis in patients with head and neck cancers, or leukemia (Javadzadeh Bolouri et al, 2015 ; Eslami et al, 2016 ). However, early report of a double blind randomized placebo controlled trial shows that propolis cannot be recommended for severe oral mucositis in chemotherapy-treated pediatric patients (Tomazevic and Jazbec, 2013 ).…”

Double-blind randomized phase III study comparing a mixture of natural agents versus placebo in the prevention of acute mucositis during chemoradiotherapy for head and neck cancer

“…Although this was a double‐blind study, the limited (N = 40) number of randomized patients and the lack of correction for the individual amount of mucosa included in the radiotherapy fields weakened the conclusions. In a randomized blind study on only 20 patients undergoing radiotherapy for head and neck cancer, patients receiving propolis mouthwashes had significantly lower grades of mucositis . In a more recent phase III study on a larger population (N = 40) treated with chemotherapy only, propolis was found to favorably impact mucosa healing after treatment but not the incidence of mucositis during treatment .…”