Determination of the efficacy of propolis in the prevention of oral mucositis in patients undergoing high-dose chemotherapy

The study was carried out to determine the efficacy of propolis in the prevention of oral mucositis in patients with leukemia, lymphoma, and myelodysplastic syndrome receiving high-dose chemotherapy and/or hematopoietic stem cell transplantation. 64 patients, 32 in the propolis and 32 in the control group, were involved in the prospective randomized controlled experimental study. While the standard oral care treatment protocol of the clinic was administered to the control group, aqueous propolis extract was applied to the propolis group in addition to the standard oral care treatment protocol. To collect the data, "Descriptive Information Form", "Karnofsky Performance Scale", "Cumulative Illness Rating Scale-Geriatric", "Patient Follow-up Form", "World Health Organization Oral Toxicity Scale" and "National Cancer Institute Common Terminology Criteria for Adverse Events" were used. The data were evaluated with Chi-square, t-test, Mann Whitney U, univariate and multivariate logistic regression analysis, Kaplan-Meier method, and Spearman correlation analysis. The incidence and duration of oral mucositis were statistically significantly lower in the propolis group than the control group, the onset of oral mucositis and grade 2-3 oral mucositis occurred later (p<0.05). Multivariate regression analysis showed that the risk of oral mucositis in the control group (OR=4.9, p=0.010) and patients receiving acute myeloid leukemia remission induction therapy/refractory or relapsed acute myeloid leukemia and acute lymphoblastic leukemia (OR=12.5, p=0.043), and the risk of grade 2-3 oral mucositis increased in the control group (OR=8.7, p=0.014) and patients with hematopoietic stem cell transplantation was found to increase (OR=5.1, p=0.031). On the other hand, in the propolis group, the incidence, and duration of oral mucosal pain were statistically significantly lower, and oral mucosal pain, dysphagia, and weight loss developed later (p<0.05). As a result, propolis mouthwash prolonged the onset of oral mucositis and decreased its incidence and the number of days it lasted. Considering these results, it is recommended to use propolis mouthwash as an oral care product in patients receiving high-dose chemotherapy.