Zinc Supplementation for Mitigating Oral Mucositis in Head and Neck Cancer Patients Undergoing Radiotherapy and Chemoradiotherapy - A Systematic Review

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-02-25 DOI:10.1016/j.clnesp.2025.02.011

Goodnews Ikuesiri Agare , Timothy Prince Chidike Ezeorba , David C. Michael , Emmanuel Agbamu , Ogheneovo Clement Aghoja , Christian A. Alalor

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引用次数: 0

Abstract

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.

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.