Effectiveness Not Established


for Mucositis

Beta-glucan is a polysaccharide of D-glucose monomers linked by glycosidic bonds. Beta-glucan has been used in medicine for a variety of conditions including high cholesterol, diabetes, HIV/AIDS, the flu, asthma, rheumatoid arthritis, and multiple sclerosis. Beta-glucans have been investigated as a possible treatment for mucositis associated with cancer treatment. 

Research Evidence Summaries

Karaca, H., Bozkurt, O., Ozaslan, E., Baldane, S., Berk, V., Inanc, M., ... Ozkan, M. (2014). Positive effects of oral beta-glucan on mucositis and leukopenia in colorectal cancer patients receiving adjuvant FOLFOX-4 combination chemotherapy. Asian Pacific Journal of Cancer Prevention, 15(8), 3641–3644. 

Study Purpose

To examine the effect of oral beta-glucan on leukocytes, neutrophils, platelets, oral mucositis, and diarrhea in a group of patients with colorectal cancer who received adjuvant FOLFOX-4 and were at high risk for these side effects

Intervention Characteristics/Basic Study Process

Sixty-two consecutive patients admitted with colorectal cancer and treated with FOLFOX-4 between July 2009 and July 2010 were divided into two equal groups to receive beta-glucan 50 mg per day for at least one week with FOLFOX-4 for the first cycle or only FOLFOX-4. Leukocyte, neutrophil, and platelet counts were obtained, and oral mucositis and diarrhea were graded one day before and one week after chemotherapy.

Sample Characteristics

  • N = 62  
  • MEDIAN AGE = 61 years (treatment); 55 years (control – no statistical difference) (range = 30–78 years)
  • MALES: 61%, FEMALES: 39%


  • SITE: Single-site    
  • SETTING TYPE: Inpatient  
  • LOCATION: Turkey

Phase of Care and Clinical Applications

  • PHASE OF CARE: Active antitumor treatment
  • APPLICATIONS: Elder care  

Study Design

A retrospective study of consecutively-admitted patients.

Measurement Instruments/Methods

  • The National Cancer Institute's Common Toxicity Criteria (NCI, CTC) were used for grading oral mucositis and diarrhea.
  • Cell counts were measured using a Siemens Advia® 2120i hemogram device.


Oral mucositis and diarrhea were observed in six (19%) patients in the treatment group and in 13 (42%) patients in the control group. Statistical analysis could not be done because of the limited number of patients. There were no beta-glucan-induced side effects reported. There was no difference in the leukocyte and neutrophil counts before and after chemotherapy in the treatment group. The platelet count difference before and after chemotherapy was significant (p = 0.048). The difference between baseline and after chemotherapy was significant (p = < 0.01) for median leukocyte, neutrophil, and platelet counts in the control group.


Oral beta-glucan showed some effectiveness in reducing oral mucositis or diarrhea in patients receiving FOLFOX-4. Results are difficult to interpret because no statistical analysis could be performed comparing the two groups.


  • Small sample (< 100)
  • Risk of bias (no control group)
  • Measurement/methods not well described
  • Other limitations/explanation: The sample description was very brief. The discussion of quality of life when it was not measured was problematic. The study did not differentiate between patients who experienced diarrhea from those who had mucositis.

Nursing Implications

In this study, beta-glucan showed some relief of oral mucositis and diarrhea in participants. The study, however, was small, and statistical analysis was not possible due the number of participants enrolled. Additionally, all patients enrolled in this study were diagnosed with colorectal cancer and received FOLFOX-4 treatment, so the results may not be generalizable to other populations. At this time, other interventions should be considered to relieve symptoms associated with oral mucositis and diarrhea corresponding to chemotherapy treatment.