Maiti, P.K., Ray, A., Mitra, T.N., Jana, U., Bhattacharya, J., & Ganguly, S. (2012). The effect of honey on mucositis induced by chemoradiation in head and neck cancer. Journal of the Indian Medical Association, 110, 453–456.

To evaluate the use of natural honey for treatment of radiation mucositis

Patients were randomly assigned to the honey treatment or control group. Patients in the intervention group were instructed to take 20 ml of honey 15 minutes before radiation therapy, 15 minutes after radiation therapy, and at bedtime. On days when they had no radiation treatment, they were to take the same amount of honey 3 times per day. Patients were evaluated at baseline, weekly during treatment, and at 3 and 6 weeks after completion of radiation therapy.

• The study reported on 55 patients with head and neck cancer.
• The mean age of patients was 47.5 years with a range of 35–65 years.
• The sample was 78% male and 22% female.

The study was conducted at a single outpatient site in India.

Patients were undergoing the active antitumor treatment phase of care.

This was a randomized controlled trial.

• The World Health Organization (WHO) mucositis scale was used.
• Body weight was recorded.

The authors reported that honey delayed the onset of severe mucositis in about 80% of the intervention group, while 63% of the control group developed severe mucositis.  Grade 3 mucositis developed in 11 patients in the control group and 5 patients in the study group. No statistical analysis was done.

This study suggests that honey may help to delay the onset of mucositis in patients with head and neck cancer during radiation therapy; however, multiple limitations in this report make it impossible to draw firm conclusions.

• The sample size was small with fewer than 100 patients.
• A risk of bias exists because of the lack of blinding and an appropriate attentional control condition.
• Although the authors reported that patients were receiving chemotherapy and radiation therapy, no information was provided regarding the chemotherapy agents used, any treatment delays, or radiation dose at which mucositis developed. 
• No statistical analysis was done.

 Findings as reported from this study are inconclusive regarding any effect of honey on the development of mucositis.