The Use of Ozone Therapy in the Treatment of Radiotherapy- and Chemotherapy-Induced Mucositis: A Systematic Review

Background: Mucositis is a frequent complication of chemo- and/or radiotherapy treatments and causes great pain and discomfort to the affected patient. Ozone therapy is a widely studied treatment in numerous disciplines, first and foremost dermatology; the beneficial effects of this treatment have already been confirmed in this field, particularly in the healing of wounds caused by diabetes. However, there is a shortage of studies on the use of this treatment in the management of radio- and/or chemo-induced mucositis. Objectives: This review aims to summarise current evidence on the beneficial effects of ozone treatment in the management of chemo- and/or radio-induced mucositis. Methods: A systematic literature review was carried out on the main databases (Scopus, PubMed and WOS); for each of the included article, the analysis of risk of bias was performed. Results: Seven articles were included in this systematic review, including six preliminary animal studies and one prospective cohort study. Analysing the variables of the studies, it seems that ozone is associated with a decrease in bacterial load, oedema and inflammatory infiltrate at the level of the lesions and a decrease in thiobarbituric acid reactive substances, indicators of oxidative stress. Conclusions: The efficacy of ozone for the management of radio- and/or chemo-induced mucositis is still to be confirmed as current evidence provides only two clinical studies. However, beneficial effects were highlighted and deserve to be further investigated.