Efficacy of Honey Combined with Cryotherapy in the Prevention and Management of Radiation-Induced Oral Mucositis in Patients Undergoing Concurrent Chemoradiotherapy for Head and Neck Cancer

INTRODUCTION: The objectives of the study were to evaluate the preventive and therapeutic effects of honey combined with cryotherapy on radiation-induced oral mucositis (RTOM) in patients with head and neck cancer undergoing concurrent chemoradiotherapy and to provide evidence-based guidance for clinical prevention and management. METHODS: This study was a single-center, prospective comparative design. A total of 72 head and neck cancer patients who met the inclusion and exclusion criteria and received concurrent chemoradiotherapy in a specialized oncology institution between July 2021 and May 2022 were enrolled in this study. The patients were allocated equally into 2 groups: 1 in the intervention group (n = 36) that received honey and cryotherapy, and one in the control group (n = 36) that received routine nursing care. Interventions were applied at three time periods - prior to radiotherapy, 15 min post-radiotherapy, and 6 h afterward. The main outcome measures were onset time and grade of RTOM assessed via criteria established by the Radiation Therapy Oncology Group (RTOG). Independent-samples t and χ2 tests were utilized to analyze timing and grading outcome between groups. RESULTS: Significant differences were observed between the two groups in the onset time of RTOM (15.58 ± 4.60 days vs. 11.58 ± 6.22 days; p = 0.003) and in the incidence of grade ≥II RTOM (11.11% vs. 33.33%; p = 0.045). Statistical differences in severity grading were also observed during the second week (χ2 = 12.828, p = 0.005) and the third week (χ2 = 10.619, p = 0.014) of treatment, indicating consistent intergroup benefits. CONCLUSION: Honey in combination with cryotherapy is probably a safe, low-cost nursing intervention that could postpone the onset and severity of RTOM in head and neck cancer patients undergoing concurrent chemoradiotherapy. This could improve comfort and compliance through poorly tolerated treatment, but further validation with more comprehensive studies is needed.