Honey for managing oral mucositis induced by cancer therapies: An overview of systematic reviews.

PURPOSE: To synthesize and evaluate the quality of systematic reviews focusing on the use of honey for both the prevention and treatment of oral mucositis induced by cancer therapies. METHODS: An overview of systematic reviews was conducted by searching five electronic databases from inception to January 2024 to identify relevant studies evaluating the effectiveness of honey in the prevention and treatment of cancer therapy-induced oral mucositis. RESULTS: Twelve reviews were included, with seven (58.3 %) published after 2018. Five systematic reviews, four of which were rated as high quality, consistently found that honey significantly reduces the occurrence of severe radiation-induced oral mucositis (grades III and IV). Honey may also help alleviate severe pain requiring analgesics and reduce treatment interruptions, particularly among adult patients undergoing radiotherapy. However, findings regarding honey's effectiveness in reducing the overall incidence of radiation-induced oral mucositis, regardless of severity, were inconsistent. These discrepancies are likely due to variations in patient populations, honey formulations, and timing or duration of administration. Evidence regarding honey's efficacy in chemotherapy- and chemoradiotherapy-induced mucositis remains inconclusive due to methodological limitations, clinical heterogeneity, and a limited number of high-quality studies. CONCLUSION: Honey may be beneficial in reducing the incidence of severe oral mucositis (grades III and IV), relieving pain, and minimizing treatment disruptions in adult patients undergoing radiotherapy. However, its effectiveness across all grades and treatment modalities remains uncertain due to inconsistent findings, clinical heterogeneity, and methodological limitations. Further high-quality studies are needed to standardize honey types and dosing regimens and to stratify outcomes by mucositis grade, patient age, and cancer therapy type. STUDY REGISTRATION: PROSPERO Protocol registration ID: CRD42024532801.