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营养补充剂在头颈部癌症患者口腔黏膜炎管理中的应用:叙事性文献综述。

Nutritional supplements in the management of oral mucositis in patients with head and neck cancer: Narrative literary review.

机构信息

Department of Life Sciences, Bahia State University, Salvador, Bahia, Brazil.

Federal University of Bahia, Institute of Health Sciences, Salvador, Adventist College of Bahia, Cachoeira, Bahia, Brazil.

出版信息

Clin Nutr ESPEN. 2021 Jun;43:31-38. doi: 10.1016/j.clnesp.2021.03.030. Epub 2021 Apr 15.

Abstract

BACKGROUND AND AIMS

Oral mucositis is the most common side effect in response to anticancer therapies in the head and neck region. It has a debilitating potential for the health of affected individuals, negatively interfering with nutritional status and quality of life. Due to the great complexity of its pathogenicity, different forms of interventions for prevention and treatment are being studied, including nutritional supplements with vitamin E, zinc and glutamine. This study aimed to review the literature on the influence of nutrients, in supplement form, for prevention and/or treatment of mucositis in patients with head and neck cancer.

METHODS

A survey of studies related to the definition, treatment and prevention of mucositis with nutrients was carried out between January 2018 and July 2019, using the Pubmed, Cochrane Library and Scielo databases. In the end, 61 relevant scientific publications were selected between the years 2004 and 2019.

RESULTS

Nutrients such as vitamin E, glutamine and zinc are forms of supplementation that have positive effects on the manifestation and severity of oral mucositis due to their antioxidant and immunomodulatory properties. However, some studies reveal that antioxidant properties may reduce the effectiveness of antineoplastic therapy.

CONCLUSIONS

This study suggests the effectiveness of vitamin E, zinc and glutamine in preventing and treating oral mucositis. However, the importance of new clinical researches to clarify possible doubts is highlighted, as well as the creation of a protocol that includes the dose, route and time of administration, for greater safety in use.

摘要

背景与目的

口腔黏膜炎是头颈部癌症治疗中最常见的不良反应。它对患者的健康有极大的不良影响,会导致营养状况恶化和生活质量下降。由于其发病机制非常复杂,因此正在研究各种预防和治疗方法,包括使用维生素 E、锌和谷氨酰胺的营养补充剂。本研究旨在综述营养补充剂在预防和/或治疗头颈部癌症患者口腔黏膜炎方面的作用。

方法

2018 年 1 月至 2019 年 7 月,我们使用 Pubmed、Cochrane 图书馆和 Scielo 数据库,对有关口腔黏膜炎定义、治疗和预防的研究进行了调查。最终,我们选择了 2004 年至 2019 年间的 61 篇相关科学出版物。

结果

维生素 E、谷氨酰胺和锌等营养素具有抗氧化和免疫调节特性,因此作为补充剂形式可对口腔黏膜炎的表现和严重程度产生积极影响。然而,一些研究表明,抗氧化特性可能会降低抗肿瘤治疗的效果。

结论

本研究表明,维生素 E、锌和谷氨酰胺可有效预防和治疗口腔黏膜炎。但是,为了澄清可能存在的疑问,需要开展新的临床研究,并且要制定包括剂量、途径和给药时间的方案,以提高使用的安全性。

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