Effect of honey mouthwash and oral care protocol on weight loss among patients with acute myeloid leukemia undergoing chemotherapy

authors:

avatar Arezoo Khanjani pour-fard-pachekenari , avatar Azad Rahmani , avatar Akram Ghahramanian ORCID , * , avatar Arefeh Davoodi , avatar Mohammad Asghari Jafarabadi , avatar Jamal Eivazi Ziaei

Koomesh: Vol.21, issue 1; 52-60
published online: March 01, 2019
article type: Research Article
received: August 02, 2017
accepted: August 01, 2018

how to cite: Khanjani pour-fard-pachekenari A, Rahmani A, Ghahramanian A, Davoodi A, Asghari Jafarabadi M, et al. Effect of honey mouthwash and oral care protocol on weight loss among patients with acute myeloid leukemia undergoing chemotherapy. koomesh. 2019;21(1):e153037. 

Abstract

Introduction: Patients with cancer during their chemotherapy period are more at risk for nutritional problems and weight loss due to oral problems. Over the years, oral care protocols and mouthwashes have been developed to control this problem. Recently, in some studies, the effect of oral care programs and honey on the nutritional status of patients under chemotherapy has been studied. The aim of this study was to compare the effect of honey mouthwash and an oral care protocol on weight loss in patients with acute myeloid leukemia (AML) undergoing chemotherapy. Materials and Methods: In this single-blind clinical trial, sixty patients with AML under chemotherapy admitted to Ghazi Tabatabaee hospital of Tabriz, Iran were selected with convenience sampling and were randomly assigned into three groups: honey mouthwash (n=20) and oral care (n=20) and a control group (n=20). In addition to routine care, patients in the oral care group received twice daily toothbrush, dental floss was used once a day and normal saline mouthwash, and in the honey group, honey mouthwash was used four times a day for 30 seconds (honey to water ratio 1:20). The weight of patients was measured using a digital scale at baseline and at 4 weeks follow-up (4 times). Results: The trend of weight changes in the control group was decreasing in the honey mouthwash group, after the first week was ascending, and in the oral care group, it was almost constant.Importantly,comparison of mean weight in the study groups during the first and second weeks was not significant (p>0.05) but at the end of the third week, the difference of mean weight of the patients in the honey and control group (p=0.039) and at the end of the week in the honey and control group (p=0.001) and honey and oral care (p=0.04) were significant. The effect of intervention of honey mouthwash was significant over time (p

References

  • 1.

    Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin 2018; 68: 7-30.

  • 2.

    Keyghobadi N, Rafiemanesh H, Mohammadian-Hafshejani A, Enayatrad M, Salehiniya H. Epidemiology and trend of cancers in the province of Kerman: southeast of Iran. Asian Pacific J Cancer Prev 2015; 16: 1409-1413. (Persian).

  • 3.

    Saadat S, Yousefifard M, Asady H, Fayaz M, Hosseini M. The most important causes of death in Iranian population; a retrospective cohort study. Emergency 2015; 3: 16-21 (Persian).

  • 4.

    Co JL, Mejia MBA, Que JC, Dizon JMR. Effectiveness of honey on radiationinduced oral mucositis, time to mucositis, weight loss, and treatment interruptions among patients with head and neck malignancies: A metaanalysis and systematic review of literature. Head Neck 2016; 38: 1119-1128.

  • 5.

    Vera-Llonch M, Oster G, Ford CM, Lu J, Sonis S. Oral mucositis and outcomes of allogeneic hematopoietic stem-cell transplantation in patients with hematologic malignancies. Support Care Cancer 2007; 15: 491-496.

  • 6.

    Raber-Durlacher JE, Elad S, Barasch A. Oral mucositis. Oral Oncol 2010; 46: 452-456.

  • 7.

    Eilers J. When the mouth tells us more than it says-the impact of mucositis on quality of life. Oncol Support Care Quart 2004; 1: 31-43.

  • 8.

    Rubenstein EB, Peterson DE, Schubert M, Keefe D, McGuire D, Epstein J, et al. Clinical practice guidelines for the prevention and treatment of cancer therapyinduced oral and gastrointestinal mucositis. Cancer 2004; 100: 2026-2046.

  • 9.

    Clarkson JE, Worthington HV, Furness S, McCabe M, Khalid T, Meyer S. Interventions for treating oral mucositis for patients with cancer receiving treatment. Cochrane Database Syst Rev 2010; 8: 1-79.

  • 10.

    Santarpia L, Contaldo F, Pasanisi F. Nutritional screening and early treatment of malnutrition in cancer patients. J Cachexia Sarcopenia Muscle 2011; 2: 27-35.

  • 11.

    Langius JA, Twisk J, Kampman M, Doornaert P, Kramer MH, Weijs PJ, Leemans CR. Prediction model to predict critical weight loss in patients with head and neck cancer during (chemo) radiotherapy. Oral Oncol 2016; 52: 91-96.

  • 12.

    Baharvand M, Sarrafi M, Alavi K. Efficacy of topical phenytoin on chemotherapy-induced oral mucositis; a pilot study. Daru J Facul Pharmacy Tehran Univ Med Sci 2009; 18: 46-50 (Persian).

  • 13.

    Sahebjamee M, Mansourian A, Mohammad M, Haji M, Zadeh MT, Bekhradi R, et al. Comparative efficacy of aloe vera and benzydamine mouthwashes on radiation-induced oral mucositis: a triple-blind, randomised, controlled clinical trial. Oral Health Prev Dentist 2015; 13: 1-7 (Persian).

  • 14.

    Boyle P, Koechlin A, Autier P. Mouthwash use and the prevention of plaque, gingivitis and caries. Oral Dis 2014; 20: 1-68.

  • 15.

    Oryan A, Alemzadeh E, Moshiri A. Biological properties and therapeutic activities of honey in wound healing: a narrative review and meta-analysis. J Tissue Viability 2016; 25: 98-118.

  • 16.

    Biswal BM, Zakaria A, Ahmad NM. Topical application of honey in the management of radiation mucositis.A preliminary study. Support Care Cancer 2003; 11: 242-248.

  • 17.

    Khanal B, Baliga M, Uppal N. Effect of topical honey on limitation of radiation-induced oral mucositis: an intervention study. Int J Oral Maxillo Surg 2010; 39: 1181-1185.

  • 18.

    Motallebnejad M, Akram S, Moghadamnia A, Moulana Z, Omidi S. The effect of topical application of pure honey on radiation-induced mucositis: a randomized clinical trial. J Contemp Dent Pract 2008; 9: 40-47.

  • 19.

    Rashad U, Al-Gezawy S, El-Gezawy E, Azzaz A. Honey as topical prophylaxis against radiochemotherapy-induced mucositis in head and neck cancer. J Laryngol Otol 2009; 123: 223-228.

  • 20.

    Ghadiri K, Farokhi A, Akramipour R, Rezaei M, Razaghei R. Effect of honey use in preventing the occurrence and reduction of mucositis severity Chemotherapy in children with cancer. J Kermanshah Univ Med Sci 2014; 18: 74-79 (Persian).

  • 21.

    Hawley P, Hovan A, McGahan CE, Saunders D. A randomized placebo-controlled trial of manuka honey for radiation-induced oral mucositis. Support Care Cancer 2014; 22: 751-761.

  • 22.

    Eilers J, Million R, editors. Prevention and management of oral mucositis in patients with cancer. Semin Oncol Nurs 2007; 23: 201-212.

  • 23.

    Peterson D, Bensadoun RJ, Roila F. Management of oral and gastrointestinal mucositis: ESMO clinical practice guidelines. Ann Oncol 2011; 22: vi78-vi84.

  • 24.

    Gheyratiyan MM, Mottaghi-nejad M. Katzong and Trevor's pharmacology (examination and board review). 10, editor. Tehran: Andisherafi; 2013 (Persian).

  • 25.

    Snchez-Lara K, Ugalde-Morales E, Motola-Kuba D, Green D. Gastrointestinal symptoms and weight loss in cancer patients receiving chemotherapy. Br J Nutr 2013; 109: 894-897.

  • 26.

    Nagi R, Patil DJ, Rakesh N, Jain S, Sahu S. Natural agents in the management of oral mucositis in cancer patients-systematic review. J Oral Biol Craniofac Res 2018; 8:245-254.

  • 27.

    Abd-El-karim HE, Yousef YE, Ahmed SM, Hadhood SE. The therapeutic effect of honey on stomatitis complicating chemotherapy in children at sohag governorate. J Am Sci 2013; 9.

  • 28.

    Abdulrhman M, Samir Elbarbary N, Ahmed Amin D, Saeid Ebrahim R. Honey and a mixture of honey, beeswax, and olive oil-propolis extract in treatment of chemotherapy-induced oral mucositis: a randomized controlled pilot study. Pediatr Hematol Oncol 2012; 29: 285-292.

  • 29.

    Raeessi MA, Raeessi N, Panahi Y, Gharaie H, Davoudi SM, Saadat A, et al. "Coffee plus honey" versus "topical steroid" in the treatment of chemotherapy-induced oral mucositis: a randomised controlled trial. BMC Complement Altern Med 2014; 14: 293.

  • 30.

    Al Jaouni SK, Al Muhayawi MS, Hussein A, Elfiki I, Al-Raddadi R, Al Muhayawi SM, Almasaudi S, Kamal MA, Harakeh S. Effects of honey on oral mucositis among pediatric cancer patients undergoing chemo/radiotherapy treatment at king abdulaziz university hospital in Jeddah, Kingdom of Saudi Arabia.Evid Based Complement Alternat Med 2017; 2017:5861024.##.