Effectiveness of Aloe vera in the treatment of oral mucositis: a systematic review and meta-analysis of randomized controlled trials.

Abstract

Oral mucositis (OM) is a common complication of cancer patients. A systematic review and meta-analysis assessed the effectiveness of Aloe vera (AV) in the treatment of OM. The population included cancer patients undergoing radiotherapy or chemotherapy, treated for OM with AV. A search following the PICOS strategy, with specific keywords, identified randomized controlled trials (RCTs) published up to September 2024. Seven RCTs involving 355 participants, 170 in the intervention (AV) groups (mean age 39.7 years, standard deviation 23.9 years) and 185 in control groups (mean age 39.0 years, standard deviation 23.5 years), were included. A significant difference in the improvement of severe mucositis cases (grades 3 and 4) was observed with the use of AV compared to control (placebo, sodium bicarbonate, or benzydamine) (odds ratio 0.32, 95% confidence interval 0.15-0.70, P = 0.004). Considering the moderate heterogeneity observed (I² = 36%, P = 0.15), a subgroup analysis was conducted. A subgroup analysis showed significant improvement in grade 3 and 4 OM for AV versus placebo (odds ratio 0.22, 95% CI 0.11-0.44, P < 0.001), but not compared with sodium bicarbonate or benzydamine. The results suggest that AV may be beneficial for cancer patients undergoing radiotherapy or chemotherapy, leading to improvements in the more severe stages of OM.