Department of Hospital Dentistry, Walter Reed National Military Medical Center, Bethesda, MD, USA.
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Support Care Cancer. 2020 Dec;28(12):1-12. doi: 10.1007/s00520-020-05578-8. Epub 2020 Nov 24.
Many head and neck cancer patients who receive radiation therapy experience radiation-induced dysgeusia (RID), which has no standard treatment. The only supplement controlled clinical trials have evaluated for the treatment of RID is zinc. However, the results of these and other studies investigating the use of zinc for RID have been inconsistent. To assess the validity of zinc as a treatment for RID, we conducted a systematic literature search and performed a meta-analysis to determine the extent to which zinc affects RID incidence and the degree to which ongoing RID responds to zinc.
We searched the Ovid MEDLINE, Ovid Embase, PubMed, and Cochrane Library databases to identify studies investigating the use of zinc-based therapy for RID in head and neck cancer patients treated with radiation that were published between January 1, 2003, and November 9, 2017. Using American Society of Clinical Oncology criteria, we selected studies with a high level of evidence for inclusion in the meta-analysis.
Of the 32 full-text articles eligible for inclusion, three were included in the final review and meta-analysis. The meta-analysis showed that, compared with placebo, zinc reduces the incidence of RID (risk ratio, 0.72; 95% confidence interval, 0.67-0.92) but does not improve taste acuity more rapidly following radiation therapy (risk ratio, 2.58; 95% confidence interval, 0.97-6.88).
Our findings indicate that zinc-based therapy reduces the incidence of RID but has a minimal effect on ongoing RID. Our findings also highlight the need for additional evidence-based research on this topic.
许多接受放射治疗的头颈部癌症患者会出现放射性味觉障碍（RID），但目前尚无标准治疗方法。唯一经过对照临床试验评估用于治疗 RID 的补充剂是锌。然而，这些以及其他研究调查锌用于 RID 的结果并不一致。为了评估锌作为 RID 治疗方法的有效性，我们进行了系统的文献检索，并进行了荟萃分析，以确定锌对 RID 发生率的影响程度，以及 RID 对锌的持续反应程度。
我们检索了 Ovid MEDLINE、Ovid Embase、PubMed 和 Cochrane 图书馆数据库，以确定 2003 年 1 月 1 日至 2017 年 11 月 9 日期间发表的关于头颈部癌症患者接受放射治疗时使用锌基疗法治疗 RID 的研究。我们使用美国临床肿瘤学会标准选择具有高水平证据的研究纳入荟萃分析。
在 32 篇全文符合纳入标准的文章中，有 3 篇被纳入最终的综述和荟萃分析。荟萃分析表明，与安慰剂相比，锌可降低 RID 的发生率（风险比，0.72；95%置信区间，0.67-0.92），但在放射治疗后味觉锐度改善速度没有更快（风险比，2.58；95%置信区间，0.97-6.88）。
我们的研究结果表明，锌基疗法可降低 RID 的发生率，但对持续的 RID 影响很小。我们的研究结果还强调了在这一主题上需要进行更多基于证据的研究。
