补充锌对减轻接受放疗和放化疗的头颈癌患者口腔黏膜炎的作用——一项系统评价
Zinc Supplementation for Mitigating Oral Mucositis in Head and Neck Cancer Patients Undergoing Radiotherapy and Chemoradiotherapy - A Systematic Review.
作者信息
Agare Goodnews Ikuesiri, Chidike Ezeorba Timothy Prince, Michael David C, Agbamu Emmanuel, Aghoja Ogheneovo Clement, Alalor Christian A
机构信息
Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, United Kingdom; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Delta State University, Delta State, 330105, Nigeria.
Department of Biochemistry, Faculty of Biological Sciences, University of Nigeria, Enugu State, 410001, Nigeria; Department of Environmental Health and Risk Management, College of Life and Environment Sciences, University of Birmingham, United Kingdom.
出版信息
Clin Nutr ESPEN. 2025 Jun;67:8-24. doi: 10.1016/j.clnesp.2025.02.011. Epub 2025 Feb 25.
BACKGROUND & AIMS: Head and Neck Cancers (HNCs) pose a significant global health burden, with increasing incidence projected by 2030. Treatment typically involves radiotherapy (RT) and chemoradiotherapy (CMRT), often leading to debilitating oral mucositis (OM), which impairs quality of life and may treatment discontinuation. Currently, there are no established preventive and therapeutic measures for OM in HNC patients. This systematic review aims to consolidate available evidence on the efficacy of zinc supplementation in mitigating the onset, duration, and severity of OM during RT and CMRT in HNC patients.
METHODS
We searched the Medline, Embase, and Web of Science databases for studies on HNC patients receiving RT or CMRT with zinc supplementation from January 2013 to July 2023. Search terms included various HNC, RT, chemoradiotherapy, and zinc supplementation permutations. Only interventional studies were included, with quality assessment conducted using the JBI risk of bias tools. Findings were synthesized narratively.
RESULTS
Eight studies involving 651 HNC patients, comprising six randomized controlled trials (RCTs) and two non-randomized controlled trials, were included. Various radiotherapy techniques and concurrent chemotherapy were utilized across studies, with zinc administered in multiple forms including syrup, tablets, suspension, topical application, and mouthwashes. Overall, six studies reported a beneficial effect of zinc supplementation in reducing the incidence, onset, duration, and severity of OM, while two studies reported no significant impact.
CONCLUSION
Zinc supplementation shows promise in ameliorating OM in HNC patients undergoing RT and chemoradiotherapy, likely due to its antioxidative, anti-inflammatory, and wound healing properties. Further research is warranted to elucidate optimal dosage and regimen for zinc supplementation in this context.
背景与目的
头颈癌（HNC）给全球健康带来了重大负担，预计到2030年发病率还会上升。治疗通常包括放疗（RT）和放化疗（CMRT），这常常会导致使人虚弱的口腔黏膜炎（OM），影响生活质量，并可能导致治疗中断。目前，对于头颈癌患者的口腔黏膜炎尚无既定的预防和治疗措施。本系统评价旨在汇总关于补充锌对减轻头颈癌患者在放疗和放化疗期间口腔黏膜炎的发生、持续时间和严重程度的疗效的现有证据。
方法
我们在Medline、Embase和科学网数据库中检索了2013年1月至2023年7月期间接受放疗或放化疗并补充锌的头颈癌患者的研究。检索词包括各种头颈癌、放疗、放化疗和补充锌的不同组合。仅纳入干预性研究，使用JBI偏倚风险工具进行质量评估。结果采用叙述性综合分析。
结果
纳入了八项涉及651名头颈癌患者的研究，包括六项随机对照试验（RCT）和两项非随机对照试验。各项研究采用了不同的放疗技术和同步化疗，锌以多种形式给药，包括糖浆、片剂、混悬液、局部应用和漱口水。总体而言，六项研究报告补充锌在降低口腔黏膜炎的发生率、发生时间、持续时间和严重程度方面有有益效果，而两项研究报告无显著影响。
结论
补充锌有望改善接受放疗和放化疗的头颈癌患者的口腔黏膜炎，这可能归因于其抗氧化、抗炎和促进伤口愈合的特性。有必要进一步研究以阐明在此背景下补充锌的最佳剂量和方案。
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