To our knowledge, this is only the second study that reported the use of oral aloe vera for reduction of radiation induced mucositis. In the first study by Su et al (25), results showed that oral aloe vera was not a beneficial adjunct to head and neck radiotherapy compared with placebo. With respect to the onset of mucositis, percentages of weight loss, the incidence of radiation break due to mucositis, and the use of medications to relief symptoms, our findings are in agreement with those of Su et al. However, our finding reports showed that the incidence of severe mucositis was lower and there was a statistically significant clinical benefit with aloe vera use. These findings might be explained by a difference in the preparation of our solution which was done by the aloe vera research group, Faculty of Pharmacy, Mahidol University. In this study, we used a fresh aloe vera gel under well-controlled technique of enzyme deactivation. Thus, our solution could preserve more essential active compounds such as glycoproteins which are powerful substances to promote healing and anti-inflammatory effects. In addition, the study of Danhof et al (26) also confirmed that fresh aloe gel promotes dermal wound healing better than existing commercial products.