Abstract: Objective: To evaluate the effects of nine mouthwashes on the prevention of oral mucositis (OM) in patients with cancer by network Meta-analysis. Methods: Databases including PubMed, Embase, Scopus, the Cochrane Library, Google Scholar, CNKI, VIP, CBM, and WanFang were searched. Studies were limited to randomized control trials (RCT) about the effects of nine mouthwashes in the prevention of OM up to August 2018. The Cochrane Handbook was used to evaluate the methodological quality. Two authors screened literature and extracted data independently. The network Meta-analysis was performed using Stata 15.0 softwares. Results: A total of 28 RCTs involving 1 811 patients were included. The network Meta-analysis results showed that chlorhexidine, benzydamine, honey and curcumin significantly reduce incidence of mucositis compared to placebo (P<0.05), honey and curcumin significantly reduce incidence of mucositis compared to povidone-iodine (P<0.05). According to SUCRA, probability ranking in descending order is curcumin, honey, benzydamine, chlorhexidine, allopurinol, sucralfate, GM-CSF, povidone-iodine, aloe. Conclusion: This Meta-analysis found that curcumin is significantly effective in preventing the incidence of oral mucositis in patients with cancer compared with other mouthwashes. However, more randomized controlled trials with larger sample size are needed for further verification.

Key words: mucositis; oral; nursing; cancer; network Meta-analysis