The effect of different mouthwashes to prevent oral mucositis in patients with radiotherapy and chemotherapy: a network meta-analysis

Abstract Background Oral mucositis (OM), as a common adverse effect in patients with chemotherapies, affects the convalescent quality of life. Currently, an increasing number of mouthwashes have been used to improve the incidence of OM in patients undergoing with radiotherapy and chemotherapy. Most...

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Main Authors: Zhixia Zhang, Jiating Song, Ling Li, Li Yuan
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Complementary Medicine and Therapies
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Online Access:https://doi.org/10.1186/s12906-025-04930-x
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author Zhixia Zhang
Jiating Song
Ling Li
Li Yuan
author_facet Zhixia Zhang
Jiating Song
Ling Li
Li Yuan
author_sort Zhixia Zhang
collection DOAJ
description Abstract Background Oral mucositis (OM), as a common adverse effect in patients with chemotherapies, affects the convalescent quality of life. Currently, an increasing number of mouthwashes have been used to improve the incidence of OM in patients undergoing with radiotherapy and chemotherapy. Most studies are comparisons of two arms or three groups, resulting in the lack of direct comparative trial evidence for all care fluids.Therefore, it is not clear which mouthwash is better for preventing the occurrence of OM in patients. This study compares the preventive effects of13 mouthwashes currently used to treat OM in different countries. Methods A computerized search was performed for randomized controlled trials on the use of mouthwash to prevent OM published in databases, such as PubMed, Embase, Web of Science, The Cochrane Library, and China National Knowledge Infrastructure until April 2023. Two investigators used the Cochrane manual to perform a bias risk assessment of the included RCTs and RevMan5.3 to plot the risk bias. Then, a network meta-analysis of the obtained data was performed using Stata 16.2 software. Results A total of 36 randomized controlled trials were included. In the network meta-analysis, the effect of 13 mouthwashes to prevent the occurrence of OM were ranked according to the size of the surface under the cumulative ranking (SUCRA) probability curve value, from best to worst were: aloe vera juice, Chinese herbal medicine, Bing Peng San, honey, Lactobacterium shorti, chamomile, riboflavin, rehabilitation solution, benzydamine, turmeric, aluminum sulfide, povidone-iodine, and chlorhexidine. Conclusion According to the SUCRA ranking results, aloe juice can better prevent OM in other chemoradiotherapy patients than other oral mouthwashes. However, this conclusion still needs to be further verified by randomized controlled trials with a larger sample. Clinical trial number Not applicable.
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spelling doaj-art-68d93ec69ce44ad6b5c5a91789fd2d2f2025-08-20T04:01:18ZengBMCBMC Complementary Medicine and Therapies2662-76712025-07-0125111210.1186/s12906-025-04930-xThe effect of different mouthwashes to prevent oral mucositis in patients with radiotherapy and chemotherapy: a network meta-analysisZhixia Zhang0Jiating Song1Ling Li2Li Yuan3Nursing Department, Guangdong Provincial Hospital of Chinese Medicine ZhuhaiNursing Department, Guangdong Provincial Hospital of Chinese Medicine ZhuhaiOphthalmology and Otolaryngology Department, Guangdong Provincial Hospital of Chinese Medicine ZhuhaiThe Second Clinical Medical College, Guangzhou University of Chinese Medicine ZhuhaiAbstract Background Oral mucositis (OM), as a common adverse effect in patients with chemotherapies, affects the convalescent quality of life. Currently, an increasing number of mouthwashes have been used to improve the incidence of OM in patients undergoing with radiotherapy and chemotherapy. Most studies are comparisons of two arms or three groups, resulting in the lack of direct comparative trial evidence for all care fluids.Therefore, it is not clear which mouthwash is better for preventing the occurrence of OM in patients. This study compares the preventive effects of13 mouthwashes currently used to treat OM in different countries. Methods A computerized search was performed for randomized controlled trials on the use of mouthwash to prevent OM published in databases, such as PubMed, Embase, Web of Science, The Cochrane Library, and China National Knowledge Infrastructure until April 2023. Two investigators used the Cochrane manual to perform a bias risk assessment of the included RCTs and RevMan5.3 to plot the risk bias. Then, a network meta-analysis of the obtained data was performed using Stata 16.2 software. Results A total of 36 randomized controlled trials were included. In the network meta-analysis, the effect of 13 mouthwashes to prevent the occurrence of OM were ranked according to the size of the surface under the cumulative ranking (SUCRA) probability curve value, from best to worst were: aloe vera juice, Chinese herbal medicine, Bing Peng San, honey, Lactobacterium shorti, chamomile, riboflavin, rehabilitation solution, benzydamine, turmeric, aluminum sulfide, povidone-iodine, and chlorhexidine. Conclusion According to the SUCRA ranking results, aloe juice can better prevent OM in other chemoradiotherapy patients than other oral mouthwashes. However, this conclusion still needs to be further verified by randomized controlled trials with a larger sample. Clinical trial number Not applicable.https://doi.org/10.1186/s12906-025-04930-xMouthwashRadiotherapy and chemotherapyOral mucositisNet-work meta
spellingShingle Zhixia Zhang
Jiating Song
Ling Li
Li Yuan
The effect of different mouthwashes to prevent oral mucositis in patients with radiotherapy and chemotherapy: a network meta-analysis
BMC Complementary Medicine and Therapies
Mouthwash
Radiotherapy and chemotherapy
Oral mucositis
Net-work meta
title The effect of different mouthwashes to prevent oral mucositis in patients with radiotherapy and chemotherapy: a network meta-analysis
title_full The effect of different mouthwashes to prevent oral mucositis in patients with radiotherapy and chemotherapy: a network meta-analysis
title_fullStr The effect of different mouthwashes to prevent oral mucositis in patients with radiotherapy and chemotherapy: a network meta-analysis
title_full_unstemmed The effect of different mouthwashes to prevent oral mucositis in patients with radiotherapy and chemotherapy: a network meta-analysis
title_short The effect of different mouthwashes to prevent oral mucositis in patients with radiotherapy and chemotherapy: a network meta-analysis
title_sort effect of different mouthwashes to prevent oral mucositis in patients with radiotherapy and chemotherapy a network meta analysis
topic Mouthwash
Radiotherapy and chemotherapy
Oral mucositis
Net-work meta
url https://doi.org/10.1186/s12906-025-04930-x
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