Cancer remains a leading global cause of mortality, with its therapeutic side effects considerably compromising patients' quality of life (“World health statistics 2022: monitoring health for the SDGs, sustainable development goals.,” 2022). Oral mucositis ranks among the prevalent side effects of cancer therapies, typically manifesting 5-14 days post-initiation of chemotherapy or radiotherapy (Gupta and West, 2016). Notably, patients with head and neck cancer undergoing high-dose radiation therapy exhibit an incidence rate of oral mucositis between 85%-100% (Lalla et al., 2014, Maria et al., 2017). Beyond inducing oral discomfort, severe mucosal injuries can precipitate complications like dysphagia, weight loss, and treatment interruptions. Such complications not only diminish the treatment's efficacy but also adversely affect patient survival rates (Lalla et al., 2014, Villa and Sonis, 2015).

The Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology have established clinical guidelines addressing oral mucositis resulting from cancer therapies. These guidelines advocate for mouthwashes containing anti-inflammatory or analgesic agents and endorse non-invasive therapeutic modalities such as low-intensity light/laser therapy and oral cryotherapy (Yarom et al., 2020, Yarom et al., 2013). Furthermore, the guidelines emphasize the significance of supportive therapies, such as the supplementation of specific nutrients and vitamins, as complementary approaches alongside medications. With the rising inclination towards naturopathy, a plethora of studies underscore the therapeutic advantages of natural products in this domain (Elad et al., 2020, Lalla et al., 2014, Lima et al., 2021, Yarom et al., 2020).

Natural products, sourced from both flora and fauna, can be obtained directly from entities like plant flowers, roots, and fruits, or from bee-derived substances such as honey and propolis. They may also be by-products of plant metabolic processes (Nobili et al., 2009). Research has spotlighted the therapeutic prowess of certain natural products, such as honey (Biswal et al., 2003) and aloe vera (Su et al., 2004), in alleviating cancer treatment-induced oral mucositis, with minimal side effects. However, the vast array of natural products, each requiring distinct extraction techniques, introduces complexities. Despite their widespread use, a consensus on their efficacy in managing cancer-induced oral mucositis remains elusive. Previous network meta-analyses combined evaluations of both pharmacological and non-pharmacological interventions for preventing or treating oral mucositis, making it challenging to discern the specific effectiveness of natural products alone (Peng et al., 2022). This study aims to bridge this knowledge gap, employing a systematic review and network meta-analysis to assess the efficacy of various natural products in preventing or treating oral mucositis associated with cancer treatments.