Chaitanya Nallan Csk, Muthukrishnan Arvind, Babu Dara Balaji Gandhi, Kumari Chinta Sanjeeva, Lakshmi Madishetty Adi, Palat Gayathri, Alam Khwaja Shoeb
Phd Research Scholar, Department of Oral Medicine and Radiology, Saveetha University, Chennai, Tamil Nadu, India.
Professor and Guide, Department of Oral Medicine And Radiology, Saveetha University, Saveetha Dental College, Chennai, Tamil Nadu, India.
J Clin Diagn Res. 2017 May;11(5):ZE06-ZE09. doi: 10.7860/JCDR/2017/26845.9905. Epub 2017 May 1.
Oral mucositis is known to hamper the quality of life in patients treated for oral cancer. Many pharmacological agents have been tried and tested in its management, especially vitamin supplements including A, E and their combinations.
A Meta-analysis was carried out to evaluate the efficacy of vitamins individually used for prevention or treatment of oral mucositis separately for chemotherapy, concurrent chemo radiotherapy, radiotherapy and Haematopoietic Stem Cell Transplantation (HSCT) individuals.
The literature study was done using PUBMED, MEDLINE, EBSCO, GOOGLE SCHOLAR and COCHRANE data bases with keywords vitamin A, vitamin E, vitamin B, vitamin C, Oral mucositis, Chemotherapy, Radiotherapy, Concurrent chemo radiotherapy and Haematopoietic stem cell transplantation individually, from the year 1980 to 2016. Only randomized controlled trials were included. The data was extracted, tabulated and was subjected to statistical analysis with CI of 95%.
Among 201 subjects the analysis clearly demonstrated a male predominance to females in studies where male to female ratio was given. Out of 8 studies, 2 were studies in children and remaining 6 studies concentrated on adult population. WHO and NCI-CTC criteria were followed except for one study which used customised assessment. A meta-analysis was performed regarding usage of topical medication of Vitamin E group in all three cancer treatment modalities, which showed significant reduction in oral mucositis (p < 0.001). There was reduced oral mucositis in a small group of patients with Vitamin A when compared to controls. No information on the agent used for chemotherapy, the dose of radiotherapy and the type of tumours in 4 studies.
Topical Vitamin E had performed better on oral mucositis than Vitamin E systemic administration. Though the efficacy of topical treatment with Vitamin A showed reduction in oral mucositis, it was evaluated in a very small sample which cannot be attributed to a larger sitting.
众所周知，口腔黏膜炎会影响口腔癌患者的生活质量。人们已经尝试并测试了许多药物来治疗口腔黏膜炎，特别是包括维生素A、E及其组合在内的维生素补充剂。
进行一项荟萃分析，以评估单独使用维生素预防或治疗口腔黏膜炎的疗效，这些口腔黏膜炎分别发生在接受化疗、同步放化疗、放疗和造血干细胞移植（HSCT）的患者中。
使用PUBMED、MEDLINE、EBSCO、谷歌学术和Cochrane数据库进行文献研究，关键词分别为维生素A、维生素E、维生素B、维生素C、口腔黏膜炎、化疗、放疗、同步放化疗和造血干细胞移植，时间跨度为1980年至2016年。仅纳入随机对照试验。提取数据并制成表格，进行95%置信区间的统计分析。
在201名受试者中，在给出男女比例的研究中，分析清楚地表明男性多于女性。在8项研究中，2项是针对儿童的研究，其余6项研究集中在成年人群体。除了一项使用定制评估的研究外，均遵循了世界卫生组织（WHO）和美国国立癌症研究所常见毒性标准（NCI-CTC）。对维生素E组在所有三种癌症治疗方式中局部用药的使用情况进行了荟萃分析，结果显示口腔黏膜炎显著减少（p < 0.001）。与对照组相比，一小部分使用维生素A的患者口腔黏膜炎有所减轻。4项研究中没有关于所用化疗药物、放疗剂量和肿瘤类型的信息。
局部使用维生素E治疗口腔黏膜炎的效果优于维生素E全身给药。尽管局部使用维生素A治疗的疗效显示口腔黏膜炎有所减轻，但该评估是在非常小的样本中进行的，不能推广到更大的范围。
