Introduction:
Oral mucositis (OM) is the most prevalent side effect in patients with
head and neck cancer (HNC). It causes an obvious decrease in quality of life (QoL) in these patients, so different medications have been recommended for OM, however, without optimal response. This randomized trial aimed to assess the effects of a honey-lemon spray compared with
benzydamine hydrochloride in prevention of radiation-induced OM in patients with HNC. Materials and Methods: Forty-six patients with HNC received external beam
radiotherapy for 5 days per week. Patients were randomized to treatment with either
benzydamine hydrochloride spray or honey-lemon spray for 5 weeks and continued for 1 week after the end of treatment. The oral cavity was examined weekly, with a score given to each site based on the degree of
mucositis using a 4-point scale, and a mean
mucositis score was calculated as the primary outcome. Occurrence of OM,
pain, QoL, and adverse effects were defined as secondary outcomes. Patients, therapists, and outcome assessors were blinded to group allocation. Results: No significant group differences occurred in the
mucositis score,
pain, or QoL.
Mucositis occurrence rates were higher in the
benzydamine hydrochloride group compared with the honey-lemon group (hazard ratio = 2.1, 95% confidence interval: 1.1 to 4.2). Two patients in the honey-lemon group had mild
nausea and burning throat; no adverse effects occurred in the
benzydamine hydrochloride group. Conclusions: There were no significant group differences in
mucositis severity between patients treated with honey-lemon spray and
benzydamine hydrochloride. The potential preventive effects of honey-lemon spray need to be confirmed in further trials. The trial registration number is IRCT20161024030467N1.