Table 1.

Summary of randomized trials on honey and radiation therapy. All studies had positive results for honey.

First Author/Year/Jadad Score	Sample; Intervention and Control Group	Endpoints (OM = Oral Mucositis; QoL = Quality of Life)	Main Results (OM = Oral Mucositis; QoL = Quality of Life)
Charalambous 2018 [21] 3	86 patients Group 1: 43 patients with diluted thyme honey (20 mL of thyme honey in 100 mL water making gargles in the oral cavity—¼ h before and after radiotherapy and 6 h later) Group 2: 43 patients with saline 0.9%	OM grade Weight loss Oral problems (i.e., swallowing, drinking, eating, mouth and throat pain) QoL	Lower grades of OM Better maintenance of body weight Improvement in global health Better QoL in the honey group No study discontinuation because of honey
Amanat 2017 [22] 3	82 patients Group 1: 41 patients with ziziphus honey (20 mL—¼ h before and after the radiotherapy) Group 2: 25 patients with saline 0.9%	OM grade	Lower grades of OM in the honey group No study discontinuation because of honey
Bahramnezhad 2015 [23] 0	105 patients Group 1: 35 patients with diluted polyfloral honey (50 mL honey and 25 mL water—administration schedule not given) Group 2: 35 patients with water Group 3: 35 patients with water chamomile	OM grade	Lowest grades of OM in the honey group No study discontinuation because of honey
Alvi 2013 [24] 2	60 patients Group 1: 30 patients with polyfloral honey (20 mL—¼ h before and after radiotherapy and 6 h later) Group 2: 30 patients with saline 0.9%	OM grade Weight loss Treatment discontinuation	Lower grades of OM Better maintenance of body weight No study discontinuation because of honey in the honey group No discontinuation of radiotherapy in the honey group (0 vs. 3 in the control group)
Jayachandran [25] 2012 2	60 patients Group 1: 20 patients with polyfloral honey (20 mL—¼ h before and after radiotherapy and 6 h later) Group 2: 20 patients with benzydamine hydrochloride Group 3: 20 patients with saline 0.9%	OM grade Onset of OM Recovery after end of therapy	Later onset of OM Lower grades of OM during radiotherapy Faster recovery from OM after the end of radiotherapy in the honey group No study discontinuation because of honey
Khanal 2010 [26] 2	40 patients Group 1: 20 patients with polyfloral honey (20 mL—¼ h before and after radiotherapy and before going to bed) Group 2: 20 patients with lignocaine Gel	OM grade Pain associated with OM	Lower grades of OM Less pain in the honey group No study discontinuation because of honey
Motallebnejad 2008 [27] 2	40 patients Group 1: 20 patients with thyme and astragal honey (20 mL—¼ h before and after radiotherapy and 6 h later) Group 2: 20 patients with saline 0.9%	OM grade Weight loss	Lower grades of OM Better maintenance of body weight in the honey group 4 patients in the honey group with Grade 0 OM discontinued treatment
Biswal 2003 [28] 2	40 patients Group 1: 20 patients with tea plant honey (20 mL—¼ h before and after radiotherapy and 6 h later) Group 2: 20 patients with saline 0.9%	OM grade Weight loss Treatment discontinuation Duration of mucositis	Lower percentage of patients with grade 3/4 mucositis Better maintenance of body weight in the honey group No discontinuation of radiotherapy in the honey group (0% vs. 20% in the control group) Duration of mucositis = n.s. No report of study discontinuation because of honey