BACKGROUND:Mucositis is an inflammatory response of mucosal epithelial cells to the cytotoxic effects of chemotherapy and radiation therapy. To assess the comparative efficacy of honey for patients with cancer undergoing chemo/radiotherapy-induced oral mucositis through a systematic review and network meta-analysis. METHODS:A network meta-analysis was used to identify evidence from relevant randomized controlled trials (RCTs). We searched PubMed, Embase, and the Cochrane Library for publications up to November 2017. The prespecified primary efficacy outcome was the treatment effect of moderate-severe oral mucositis with honey. We performed subgroup analyses and meta-regressions according to the age group, cancer type, mucositis cause, honey type, control arm and type of assessment scale. Moreover, secondary efficacy outcomes were treatment completed, onset time of mucositis, swallowing diary, fungal colonization, bacterial colonisation and analgesic use. And, we did standardize meta-analyses using the random-effects model, later completing the random-effects network meta-analyses by different treatment/control arms. RESULTS:A total of 17 RCTs were eligible (22 analyses), involving 1265 patients and 13 arms. Honey treatment arm significantly increased the therapeutic effect of chemo/radiotherapy-induced moderate-severe oral mucositis (0.25, 0.14-0.46); significant efficacy was observed in a large proportion of subgroups. The meta-regression may have identified the causes of heterogeneity as the honey type (P = 0.038). Therefore, we need to perform further comparisons of difference in honey types and controls by network meta-analysis, and the results from network meta-analysis revealed that pure natural honey was superior in therapeutic effect (0.05, 0.01-0.46). For secondary outcomes, significant effect was found in decreasing onset time of mucositis (0.41, 0.08-0.73), while no increase in adverse effects was observed. The study is registered with PROSPERO (CRD42017070873). CONCLUSIONS:The adjuvant treatment honey is effective and safe for patients with cancer undergoing chemo/radiotherapy-induced oral mucositis, especially applied pure natural local honey can be invoked as a first-line adjuvant therapy agent.

译文

背景:粘膜炎是粘膜上皮细胞对化学疗法和放射疗法的细胞毒性作用的炎性反应。通过系统评价和网络荟萃分析,评估蜂蜜对接受化学/放射疗法诱导的口腔粘膜炎的癌症患者的比较疗效。
方法:采用网络荟萃分析从相关随机对照试验(RCT)中鉴定证据。我们搜索了PubMed,Embase和Cochrane图书馆以查找截至2017年11月的出版物。预先确定的主要疗效结果是用蜂蜜治疗中度重度口腔粘膜炎的效果。我们根据年龄组,癌症类型,粘膜炎病因,蜂蜜类型,对照组和评估量表类型进行了亚组分析和荟萃回归。此外,次要疗效结果包括治疗完成,粘膜炎发作时间,吞咽日记,真菌定植,细菌定植和使用止痛药。并且,我们确实使用随机效应模型对荟萃分析进行了标准化,随后通过不同的治疗/对照组完成了随机效应网络的荟萃分析。
结果:总共有17项RCT(22项分析)符合条件,涉及1265例患者和13支手臂。蜂蜜治疗组显着提高了化学/放射治疗所致中度重度口腔粘膜炎的治疗效果(0.25、0.14-0.46);在很大比例的亚组中观察到显着的疗效。元回归可能已将异质性的原因确定为蜂蜜类型(P = 0.038)。因此,我们需要通过网络荟萃分析进一步比较蜂蜜类型和对照的差异,网络荟萃分析的结果表明,纯天然蜂蜜的治疗效果更好(0.05、0.01-0.46)。对于次要结果,发现减少粘膜炎的发病时间有显着效果(0.41、0.08-0.73),而未观察到不良反应增加。该研究已在PROSPERO(CRD42017070873)中注册。
结论:辅助治疗蜂蜜对癌症患者是有效且安全的,这些患者正在接受化学/放射疗法诱发的口腔粘膜炎,尤其是应用纯天然局部蜂蜜可以作为一线辅助治疗剂。

+1
+2
100研值 100研值 ¥99课程
检索文献一次
下载文献一次

去下载>

成功解锁2个技能,为你点赞

《SCI写作十大必备语法》
解决你的SCI语法难题!

技能熟练度+1

视频课《玩转文献检索》
让你成为检索达人!

恭喜完成新手挑战

手机微信扫一扫,添加好友领取

免费领《Endnote文献管理工具+教程》

微信扫码, 免费领取

手机登录

获取验证码
登录