Evidence map›Paper›PMID 40389723›Full record

Trial reportSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2025

Efficacy of synbiotic mouthwash on salivary TLR2 levels and oral mucositis in head and neck cancer patients undergoing radiotherapy: a randomized clinical trial.

Maryam Koopaie, Sahar Vaziri, Soheila Manifar, Shima Younespour, Sajad Kolahdooz

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Radiomitigators: Breakthroughs in Post-Radiation Recovery.Antioxidants (Basel, Switzerland) · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Maryam Koopaie *Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
Sahar Vaziri *School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
Soheila Manifar *Department of Oral Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. soheilaamanifar@gmail.com.
Shima YounespourDentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Sajad KolahdoozEducation and Research Network (USERN), Universal Scientific, Tehran University of Medical Sciences, Tehran, Iran.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeHead and neck squamous cell carcinoma (HNSCC) is a common type of malignancy that is often treated with radiotherapy. This treatment can lead to the development of oral mucositis. This study investigates the effectiveness of a synbiotic mouthwash in reducing the severity of oral mucositis and in modulating salivary toll-like receptor 2 (TLR2) levels in HNSCC patients undergoing radiotherapy. MATERIALS AND

methodsA triple-blind, placebo-controlled randomized clinical trial was conducted on 44 HNSCC patients, randomly assigned to either a synbiotic mouthwash (synbiotic group) or a normal saline mouthwash (placebo group). Salivary TLR2 levels were measured at baseline and after the completion of radiotherapy and oral mucositis treatment using an enzyme-linked immunosorbent assay (ELISA). The severity of oral mucositis was evaluated at each follow-up session using the MASCC/ISOO grading system. Statistical analyses included generalized estimating equations and Kaplan-Meier survival curves.

resultsCompared to the placebo group, the synbiotic group showed a significant delay in the onset of oral mucositis in grades II and III. Patients in the synbiotic group experienced a slower progression to severe mucositis, with a longer duration of grade II mucositis and fewer cases of grade III mucositis. Moreover, the mean salivary level of TLR2 in patients significantly decreased by the end of the study. However, the two groups found no statistically significant difference in salivary TLR2 levels.

conclusionsThe synbiotic mouthwash significantly reduced the severity of oral mucositis and delayed its progression in HNSCC patients undergoing radiotherapy. TLR2 levels decreased significantly in both groups. IRCT20230624058564N1, registration date: 2023-08-06. https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02591897/full https://trialsearch.who.int/Trial2.aspx?TrialID=IRCT20230624058564N1 http://en.irct.ir/trial/70874.

Indexed as

Head and Neck NeoplasmsMouthwashesSquamous Cell Carcinoma of Head and NeckStomatitisSynbioticsToll-Like Receptor 2AdultAgedDouble-Blind MethodFemaleHumansMaleMiddle AgedSalivaSeverity of Illness IndexMouthwashesTLR2 protein, humanToll-Like Receptor 2Head and neck squamous cell carcinoma (HNSCC)MouthwashOral mucositisPlacebo-controlled trialsProbioticsRadiotherapySalivaSynbioticsToll-like receptor 2 (TLR2)

Identifiers

PMID40389723

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.