Faculty of Medicine and Life Sciences, Limburg Clinical Research Center, Hasselt University, Hasselt, Belgium.
Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Florence, Italy.
Support Care Cancer. 2023 Mar 2;31(3):195. doi: 10.1007/s00520-023-07656-z.
This systematic review and meta-analysis aimed to evaluate the available literature describing the efficacy of natural and miscellaneous agents in preventing acute radiation dermatitis (RD) in cancer patients.
OVID MedLine, Embase, and Cochrane literature databases were searched from 1946 to January 2023 for randomized controlled trials studying the use of natural and miscellaneous agents to prevent RD. RevMan 5.4 was used for the meta-analysis to calculate the pooled effect sizes and 95% confidence intervals (CI) using the random effects analysis.
For the systematic review and meta-analysis, 19 and 16 studies were included, respectively. Of the five studied natural products (aloe vera, oral enzymes, olive oil, calendula, and curcumin), only oral enzymes and olive oil significantly reduced the incidence of Radiation Therapy Oncology Group grade 2 (RR: 0.42, 95%CI 0.30-0.58, p < 0.00001, RR: 0.66, 95% CI 0.51-0.85, p = 0.001, resp.). The oral enzymes also reduced the grade 3 RD incidence (RR: 0.18, 95%CI 0.06-0.55, p = 0.003). The other agents demonstrated no significant effect.
This review and meta-analysis on natural and miscellaneous agents in preventing RD in cancer patients demonstrated that oral enzymes and olive oil prevented RD severity. However, evidence supporting natural agents to prevent RD is inconsistent, mainly because of low studies numbers, low-quality study designs, and small sample sizes. Therefore, concrete conclusions cannot be made. Research on (new) natural or miscellaneous agents should focus on a randomized controlled double-blinded study design with a large patient population, a higher consistency in research methods, and clinician- and patient-reported outcomes.
本系统评价和荟萃分析旨在评估描述天然和杂项药物预防癌症患者急性放射性皮炎 (RD) 的疗效的现有文献。
从 1946 年到 2023 年 1 月，检索 OVID MedLine、Embase 和 Cochrane 文献数据库，以寻找研究使用天然和杂项药物预防 RD 的随机对照试验。使用 RevMan 5.4 进行荟萃分析，使用随机效应分析计算汇总效应大小和 95%置信区间 (CI)。
对于系统评价和荟萃分析，分别纳入了 19 项和 16 项研究。在研究的五种天然产品（芦荟、口服酶、橄榄油、金盏花和姜黄素）中，只有口服酶和橄榄油能显著降低放射治疗肿瘤学组 2 级（RR：0.42，95%CI 0.30-0.58，p<0.00001，RR：0.66，95%CI 0.51-0.85，p=0.001）的发生率。口服酶还降低了 3 级 RD 的发生率（RR：0.18，95%CI 0.06-0.55，p=0.003）。其他药物则没有明显效果。
本研究对预防癌症患者 RD 的天然和杂项药物进行了综述和荟萃分析，结果表明口服酶和橄榄油可预防 RD 的严重程度。然而，支持天然药物预防 RD 的证据并不一致，主要是因为研究数量少、研究设计质量低、样本量小。因此，无法得出确切的结论。关于（新）天然或杂项药物的研究应侧重于采用随机对照双盲设计，纳入大量患者，研究方法一致性更高，并采用临床医生和患者报告的结局。
