Head and neck carcinomas are the most common cancer in India with oral cavity being the most common subsite and squamous cell carcinoma being the most common histology. Carcinoma of oral cavity is mostly confined to the primary site, with locoregional spread. Distant metastases are seen infrequently. Management of choice is usually definitive surgery, followed by adjuvant Radiotherapy with or without concurrent chemotherapy.

Radiotherapy is delivered by using varying techniques. IMRT plays a critical role in the management of patients with head and neck (H&N) cancer. The advantage of IMRT over older/conventional techniques is that it can conform the dose to any complex target volume and avoid critical Organs at Risk (OARs).

Oral mucositis is a frequent and distressing complication of adjuvant RT in patients treated for head and neck cancers. It significantly impairs oral intake, quality of life, and may necessitate treatment breaks, thereby compromising oncologic outcomes. Benzydamine mouthwash is currently recommended for mucositis prevention but may be associated with limitations such as availability, cost, and poor patient acceptability. Honey, a natural substance with proven anti-inflammatory and wound-healing properties, has shown potential in reducing mucositis severity in preliminary studies.

However, there is a lack of robust, randomized controlled trials comparing honey gargle directly with Benzydamine mouthwash in this clinical setting. This study seeks to address this gap by evaluating whether honey gargle is non-inferior to Benzydamine mouthwash in preventing and controlling oral mucositis among post-operative head and neck cancer patients receiving adjuvant RT.