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硒对头颈部癌患者放疗期间口腔黏膜炎发生率及严重程度的影响

Effect of Selenium on Incidence and Severity of Mucositis during Radiotherapy in Patients with Head and Neck Cancer.

作者信息

Laali Elahe, Manifar Soheila, Kazemian Ali, Jahangard-Rafsanjani Zahra, Gholami Kheirollah

出版信息

Oral Health Prev Dent. 2020 Sep 4;18(4):765-771. doi: 10.3290/j.ohpd.a45080.

Abstract

PURPOSE

Oral mucositis (OM) is the most frequent side effect of radiation. Selenium deficiency leads to increased levels of free oxygen radicals and the selenium level tends to fall during radiotherapy. Hence, in this double-blind randomised controlled clinical trial, the effect of selenium was assessed in patients receiving radiation.

MATERIALS AND METHODS

Patients with head and neck cancer who were candidates to receive radiation were instructed to use selenium 200 mcg tablets twice daily. The grade of OM was evaluated by the World Health Organization (WHO) grading system on a weekly basis. The selenium level was measured at baseline and at the end of the radiation.

RESULTS

Seventy-one patients with head and neck cancer (37 in the selenium group, 34 in the placebo group) were enrolled in the study. The cumulative incidence of OM (grade 1-4) was 97.3% in the selenium and 100% in placebo group (p value: 0.79), and difference in the mean serum selenium level at the end of radiation was not statistically significant between the two groups (p value 0.24) Conclusion: Selenium supplementation does not appear to affect the selenium level as well as the severity and duration of OM. It is supposed that higher doses may be effective in the prevention of RT-mucositis. This trial was registered in the Iranian Registry of Clinical Trials accessible at www.irct.ir (ID No. IRCT2014072718612N1).

摘要

目的

口腔黏膜炎(OM)是放疗最常见的副作用。硒缺乏会导致游离氧自由基水平升高,且放疗期间硒水平往往会下降。因此,在这项双盲随机对照临床试验中,评估了硒对接受放疗患者的影响。

材料与方法

将有接受放疗指征的头颈癌患者指导其每天服用两次200微克硒片。每周采用世界卫生组织(WHO)分级系统评估OM的分级。在基线和放疗结束时测量硒水平。

结果

71名头颈癌患者(硒组37例,安慰剂组34例)纳入研究。OM(1 - 4级)的累积发生率在硒组为97.3%,安慰剂组为100%(p值:0.79),两组放疗结束时血清硒水平的差异无统计学意义(p值0.24)。结论:补充硒似乎对硒水平以及OM的严重程度和持续时间没有影响。推测更高剂量可能对预防放疗性黏膜炎有效。该试验已在伊朗临床试验注册中心注册,可在www.irct.ir查询(注册号:IRCT2014072718612N1)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a249/11654496/e04aa3a417aa/ohpd-18-4-759-g001.jpg

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