A Systematic Review of Turmeric/Curcumin for Prevention and Treatment of Oral Mucositis Due to Radiotherapy and/or Chemotherapy for Head and Neck Cancer

Abstract

Introduction:

Oral mucositis (OM) is oral mucosal damage caused by cancer treatment, including radiotherapy and chemotherapy. It is a common and debilitating adverse effect with significant impact on the quality of life. Current guidelines recommend various treatments, but the evidence base remains limited, highlighting the need for novel therapeutic approaches. Phytotherapy, including turmeric (Curcuma longa), offers potential due to its antioxidant, anti-inflammatory, antimicrobial, and wound-healing properties, which have shown promise in addressing inflammatory conditions. This systematic review aims to identify and appraise the quality of studies of turmeric/curcumin (T/C) for OM and evaluate its potential effectiveness and safety to inform future research.

Methods:

A systematic search of Medline and CINAHL databases was conducted on October 20, 2025. The Cochrane Risk of Bias v2 and GRADE tools were used to assess the risk of bias and certainty of evidence. All peer-reviewed, primary randomized controlled trials were included, which examined the effectiveness, acceptability, and/or safety of T/C for OM in head and neck cancer participants receiving radiotherapy. We included studies written in any language, published at any time, and conference abstracts if we could not retrieve the full texts but not unpublished articles. Studies were included if they evaluated products containing only turmeric or curcumin (except for flavorings). Studies that evaluated turmeric or curcumin in combination with other herbs or substances were excluded.

Results:

Nine randomized controlled trials were included, involving 503 participants. Three studies involved radiotherapy alone, and six used radio-chemotherapy. Turmeric/curcumin was administered orally (n = 3), or as mouthwashes/gels (n = 6). All studies reported superiority of turmeric/curcumin in outcomes such as severity and the onset of OM, pain, dysphagia, weight loss, hospitalization for OM, and requirement for nasogastric feeding. Adverse event reporting was generally poor, though no severe AEs were documented. Risk of bias was rated as low in five studies, with two studies rated as “some concerns” and two as “high risk.” The GRADE assessment indicated low certainty evidence for two key outcomes: severity of OM and weight loss.

Conclusion:

Turmeric/curcumin for OM management appears to show some potential. High-quality, well-designed studies are needed to assess its clinical efficacy, effectiveness, safety, acceptability, and cost-effectiveness, and the optimal route of delivery and formulation.