Efficacy and tolerability of probiotics, prebiotics, and symbiotics consumption on oral complications of patients with thyroid and head and neck cancers: a systematic review and meta-analysis
Mohammadreza Shafiei, Shayan Mardi, Soodeh Ghadimi, Helia Poorshahbazi, Roozbeh Pourabbas, M. Mehdi Keykhah, Hosein Rafiemanesh
Abstract
BACKGROUND: Oral complications following cancer treatment are a challenging issue for oncologists. Several studies have demonstrated the efficacy of biotics in the prevention and treatment of oral complications in thyroid and head and neck cancers. METHODS: Following the PRISMA criteria, a systematic review and meta-analysis of included studies on efficacy, safety, dosage, and duration of treatment was performed. RESULTS: A total of 12 randomized controlled trials and a total of 885 individuals were included in this meta-analysis. Our analysis showed that biotics had a slight but insignificant effect on the incidence of oral mucositis (Risk ratio (RR) = 0.90, 95% CI [0.79, 1.03]), and a significant impact on reducing the severity of oral mucositis (RR = 0.62, 95% CI [0.48, 0.80]). Biotics also had a slight but insignificant effect in developing xerostomia in thyroid and Head and neck cancer (HNC) patients. Subgroup meta-analysis demonstrated that Bifidobacterium-containing products were more effective than other blends. CONCLUSION: Our findings demonstrated that biotics are effective and safe for HNC and thyroid patients suffering from oral complications.