Meta-analysis of randomized controlled trials of the efficacy of propolis mouthwash in cancer therapy-induced oral mucositis

Support Care Cancer. 2018 Dec;26(12):4001-4009. doi: 10.1007/s00520-018-4344-5. Epub 2018 Jul 19.


Purpose: This meta-analysis aimed to evaluate the efficacy and safety of propolis mouthwash in cancer patients with therapy-induced oral mucositis.

Methods: This was a systematic review of randomized control trails (RCTs). We searched ten electronic databases for studies published prior to April 06, 2017. The included RCTs were published in English and Chinese. The Jadad score was used to evaluate the quality of the articles identified. Two reviewers independently evaluated each of the studies. The data were entered into Review Manager (RevMan) 5.3 software and checked for accuracy. Outcome incidence analysis was performed using odds ratios (ORs).

Results: Of the 352 articles identified, five potentially relevant articles met our inclusion criteria. These 5 RCTs included a total of 209 participants. The Jadad score for methodological quality was 3.60 ± 0.55. No obvious publication bias was noted. The incidence of severe oral mucositis was significantly lower in the propolis group than in the control group (OR = 0.35, p = 0. 003). The corresponding 95% confidence interval (CI) was 0.18 to 0.70. Between-study heterogeneity was low (I2 = 0.000, p = 0.45). No side effects were reported.

Conclusions: Propolis mouthwash is effective and safe in the treatment of severe oral mucositis. To maintain propolis safety, propolis usage should occur under the supervision of medical staff and health professionals. Future multi-center studies and a clinical protocol are needed to confirm the current findings regarding the efficacy and safety of propolis mouthwash.

Keywords: Chemotherapy or radiotherapy; Meta-analysis; Oral mucositis; Propolis mouthwash.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Humans
  • Mouthwashes / therapeutic use*
  • Neoplasms / pathology
  • Neoplasms / therapy*
  • Propolis / therapeutic use*
  • Randomized Controlled Trials as Topic / methods*
  • Stomatitis / therapy*


  • Mouthwashes
  • Propolis