Probiotics and Oral Complications of Antineoplastic Therapy in Head and Neck Cancer: A Systematic Review and Meta-Analysis

<b>Background/Objectives:</b> Patients with head and neck cancer frequently develop oral complications such as oral mucositis, infections, necrosis, and periodontal disease among others as a consequence of antineoplastic therapy. It is mainly radiotherapy that promotes oral dysbiosis, fa...

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Main Authors: Tanya Pereira-Riveros, Enric Jané-Salas, José López-López, Constanza Saka-Herran, Isabel Linares-Galiana, Teresa Vinuesa-Aumedes
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Dentistry Journal
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Online Access:https://www.mdpi.com/2304-6767/13/6/254
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author Tanya Pereira-Riveros
Enric Jané-Salas
José López-López
Constanza Saka-Herran
Isabel Linares-Galiana
Teresa Vinuesa-Aumedes
author_facet Tanya Pereira-Riveros
Enric Jané-Salas
José López-López
Constanza Saka-Herran
Isabel Linares-Galiana
Teresa Vinuesa-Aumedes
author_sort Tanya Pereira-Riveros
collection DOAJ
description <b>Background/Objectives:</b> Patients with head and neck cancer frequently develop oral complications such as oral mucositis, infections, necrosis, and periodontal disease among others as a consequence of antineoplastic therapy. It is mainly radiotherapy that promotes oral dysbiosis, favouring the overgrowth of opportunistic microorganisms. Identifying effective adjunctive strategies to prevent or mitigate these adverse effects is crucial. Recent studies have suggested that probiotics could be used to restore microbial homeostasis and modulate inflammatory responses in the oral cavity. This systematic review and meta-analysis assessed the efficacy of probiotics in alleviating oral complications associated with antineoplastic treatments in this patient population. <b>Methods:</b> A comprehensive search was conducted in PubMed, LILACS, Scopus and the Cochrane Central Register of Controlled Trials, following the PRISMA 2020 guidelines. Only randomised controlled trials (RCTs) were included. <b>Results:</b> Nine eligible RCTs were analysed using a random-effects meta-analysis. Probiotic use was significantly associated with a reduced incidence of severe (grade 3–4) oral mucositis (RR = 0.58; 95% CI: 0.41–0.81). Moderate benefits were also observed in modulating the oral microbiota and reducing levels of pathogenic bacteria and <i>Candida</i> spp. However, no significant improvements were noted in periodontal parameters or plaque indices. <b>Conclusions:</b> Probiotics show promise in the management of oral mucositis, but further well-designed trials are needed to evaluate their broader impact on oral health during cancer therapy. This review is not registered on PROSPERO.
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spelling doaj-art-cd30af7a3e2a495d98cf08a533800aa22025-08-20T02:24:29ZengMDPI AGDentistry Journal2304-67672025-06-0113625410.3390/dj13060254Probiotics and Oral Complications of Antineoplastic Therapy in Head and Neck Cancer: A Systematic Review and Meta-AnalysisTanya Pereira-Riveros0Enric Jané-Salas1José López-López2Constanza Saka-Herran3Isabel Linares-Galiana4Teresa Vinuesa-Aumedes5Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08907 L’ Hospitalet de Llobregat, Barcelona, SpainDepartment of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08907 L’ Hospitalet de Llobregat, Barcelona, SpainDepartment of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08907 L’ Hospitalet de Llobregat, Barcelona, SpainDepartment of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08907 L’ Hospitalet de Llobregat, Barcelona, SpainRadiation Oncology Department, Catalan Institute of Oncology, 08907 L’Hospitalet de Llobregat, Barcelona, SpainMicrobiology Unit, Department of Pathology and Experimental Therapeutics, School of Medicine and Health Sciences, IDIBELL, University of Barcelona, 08907 L’ Hospitalet de Llobregat, Barcelona, Spain<b>Background/Objectives:</b> Patients with head and neck cancer frequently develop oral complications such as oral mucositis, infections, necrosis, and periodontal disease among others as a consequence of antineoplastic therapy. It is mainly radiotherapy that promotes oral dysbiosis, favouring the overgrowth of opportunistic microorganisms. Identifying effective adjunctive strategies to prevent or mitigate these adverse effects is crucial. Recent studies have suggested that probiotics could be used to restore microbial homeostasis and modulate inflammatory responses in the oral cavity. This systematic review and meta-analysis assessed the efficacy of probiotics in alleviating oral complications associated with antineoplastic treatments in this patient population. <b>Methods:</b> A comprehensive search was conducted in PubMed, LILACS, Scopus and the Cochrane Central Register of Controlled Trials, following the PRISMA 2020 guidelines. Only randomised controlled trials (RCTs) were included. <b>Results:</b> Nine eligible RCTs were analysed using a random-effects meta-analysis. Probiotic use was significantly associated with a reduced incidence of severe (grade 3–4) oral mucositis (RR = 0.58; 95% CI: 0.41–0.81). Moderate benefits were also observed in modulating the oral microbiota and reducing levels of pathogenic bacteria and <i>Candida</i> spp. However, no significant improvements were noted in periodontal parameters or plaque indices. <b>Conclusions:</b> Probiotics show promise in the management of oral mucositis, but further well-designed trials are needed to evaluate their broader impact on oral health during cancer therapy. This review is not registered on PROSPERO.https://www.mdpi.com/2304-6767/13/6/254radiotherapychemotherapysurgeryprobioticshead and neck cancer
spellingShingle Tanya Pereira-Riveros
Enric Jané-Salas
José López-López
Constanza Saka-Herran
Isabel Linares-Galiana
Teresa Vinuesa-Aumedes
Probiotics and Oral Complications of Antineoplastic Therapy in Head and Neck Cancer: A Systematic Review and Meta-Analysis
Dentistry Journal
radiotherapy
chemotherapy
surgery
probiotics
head and neck cancer
title Probiotics and Oral Complications of Antineoplastic Therapy in Head and Neck Cancer: A Systematic Review and Meta-Analysis
title_full Probiotics and Oral Complications of Antineoplastic Therapy in Head and Neck Cancer: A Systematic Review and Meta-Analysis
title_fullStr Probiotics and Oral Complications of Antineoplastic Therapy in Head and Neck Cancer: A Systematic Review and Meta-Analysis
title_full_unstemmed Probiotics and Oral Complications of Antineoplastic Therapy in Head and Neck Cancer: A Systematic Review and Meta-Analysis
title_short Probiotics and Oral Complications of Antineoplastic Therapy in Head and Neck Cancer: A Systematic Review and Meta-Analysis
title_sort probiotics and oral complications of antineoplastic therapy in head and neck cancer a systematic review and meta analysis
topic radiotherapy
chemotherapy
surgery
probiotics
head and neck cancer
url https://www.mdpi.com/2304-6767/13/6/254
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