Herbal Medicine for Oral Mucositis Induced by Chemoradiation Therapy: A Systematic Review and Meta-analysis

Background: This systematic review evaluated the therapeutic and preventive effects of herbal medicines on chemoradiation-induced oral mucositis (OM).Methods: Randomized controlled trials sourced from nine electronic databases that evaluated the effectiveness of herbal medicine for OM caused by chemoradiation therapy were included. Risk-of-bias assessment and meta-analysis were conducted for selected studies.Results: This review included 63 studies involving 5,052 patients. In the meta-analysis, herbal medicine treatment significantly decreased the incidence of OM compared with the control group (n=1670; random-effects OR: 0.28, 95% CI 0.21-0.37, p<0.00001; heterogeneity I²=15%) and significantly improved the total effective rate compared with the control group (n=2874; random-effects OR: 5.10, 95% CI 3.73 -6.97, p<0.00001; heterogeneity I²=33%). Furthermore, despite high heterogeneity among studies, the herbal treatment group showed significant effects on the degree, duration, and area of OM.Conclusion: Herbal medicines may reduce the incidence of oral mucositis and improve the total effective rate in individuals undergoing cancer treatment. Therefore, herbal medicines may be used to prevent and manage OM during cancer therapy. However, conclusive interpretation is limited by the quality of evidence and heterogeneity among included studies. Further well-designed studies are required.