Liu Xin, Zhang Weifang, Chen Yifan, Rastogi Sanjay, Choudhury Rupshikha
Department of Stomatology, Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, P.R. China.
Department of Oncology Chemotherapy, Central South University Xiangya School of Medicine Affiliated Haikou People's Hospital, Haikou, Hainan 570208, P.R. China.
Exp Ther Med. 2023 May 26;26(1):347. doi: 10.3892/etm.2023.12046. eCollection 2023 Jul.
Oral mucositis (OM) is a commonly observed and debilitating side effect of chemotherapy and radiation therapy in patients with cancer, especially head and neck cancer. Although there is no proven therapy for the prevention and treatment of OM, zinc supplementation effectively decreases the incidence of OM. This paper provides a current and comprehensive meta-analysis of the efficacy of zinc compared with placebo/control in OM. A systematic literature review was conducted using MEDLINE and Central databases for randomized control trials (RCTs) comparing zinc supplementation (oral or rinse) with placebo/control in patients with various types of cancer undergoing chemotherapy, radiation therapy or combined chemo-radiation. The outcome was OM incidence, independent of the severity. A random-effects model was used to calculate the pooled risk ratio and subgroup analyses were performed. A total of 12 RCTs were included, containing information from 783 patients. A decrease in OM incidence was observed overall when all cancer therapies were considered. However, subgroup analyses showed that zinc did not significantly decrease the incidence of OM when studies were stratified by cancer therapy or scale/criteria used to assess OM. The results of the meta-analysis support the use of zinc supplementation in decreasing OM incidence in patients with cancer receiving chemotherapy or radiation therapy. However, the high heterogeneity between studies and the small number of studies are limitations of the meta-analysis.
口腔黏膜炎（OM）是癌症患者，尤其是头颈癌患者在化疗和放疗过程中常见且使人虚弱的副作用。尽管尚无经证实的预防和治疗OM的方法，但补充锌可有效降低OM的发生率。本文对锌与安慰剂/对照在OM治疗中的疗效进行了全面的最新荟萃分析。使用MEDLINE和Central数据库对随机对照试验（RCT）进行了系统的文献综述，这些试验比较了在接受化疗、放疗或联合放化疗的各类癌症患者中，补充锌（口服或漱口）与安慰剂/对照的效果。结果指标为OM发生率，不考虑严重程度。采用随机效应模型计算合并风险比，并进行亚组分析。共纳入12项RCT，涉及783例患者的信息。综合考虑所有癌症治疗方法时，总体上观察到OM发生率有所降低。然而，亚组分析显示，按癌症治疗方法或评估OM所用的量表/标准对研究进行分层时，锌并未显著降低OM的发生率。荟萃分析结果支持在接受化疗或放疗的癌症患者中使用补充锌来降低OM发生率。然而，研究之间的高度异质性和研究数量较少是该荟萃分析的局限性。
