Effects of Curcumin on Oral Mucositis: A Meta-Analysis

Objectives: This systematic review and meta-analysis aimed to evaluate the effects of curcumin in the management of oral mucositis (OM) in cancer patients undergoing radiotherapy and/or chemotherapy.
Methods: The review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search was performed at the following databases: Cochrane Library, LILACS, LIVIVO, PubMed, Scopus, and Web of Science. A partial gray literature search was undertaken using Google Scholar, Open Grey and ProQuest. The methodology of included studies was evaluated using the Meta-Analysis of Statistics Assessment and Review Instrument (MAStARI) and the evidence quality was assessed by the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) instrument. The meta-analysis was performed using the Cochrane Collaboration's Review Manager^® 5.3 software.
Results: After a two-step selection process, four randomized clinical trials and three non-randomized clinical trials were included in the analysis. Two studies were considered of low, three of moderate and two of high risk of bias. Curcumin was applied topically as a gel or a mouthwash formulation or associated with honey. Patients treated with curcumin experienced reduced mucositis, pain, erythema and ulceration. The meta-analysis resulted in a lower mean WHO mucositis grade score for patients treated with curcumin, which favored the experimental group compared to the control group (Std. Mean Difference -0.52, 95% CI: -1.16, 0.13. I² = 76%).
Conclusions: Although there are few studies on the subject, current evidence suggests that topical application of curcumin is effective in controlling the signs and symptoms of OM. Thus, further investigation is required to confirm the promising effect of curcumin in oral inflammatory lesions.