锌屏蔽：缓解头颈癌放疗和放化疗患者口腔黏膜炎的疗效-系统评价。

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

摘要

背景与目的：头颈癌（HNCs）构成重大的全球健康负担，预计到2030年发病率将增加。治疗通常包括放射治疗（RT）和放化疗（CMRT），通常导致衰弱性口腔黏膜炎（OM），导致生活质量受损，有时无法继续治疗。目前，没有针对HNC患者OM的既定预防和治疗措施。本系统综述旨在巩固现有证据，证明补充锌在缓解HNC患者在RT和CMRT期间OM的发病、持续时间和严重程度方面的有效性。方法：检索Medline、Embase和Web of Science数据库，检索2013年1月至2023年7月期间接受RT或CMRT和不同类型锌补充剂治疗的HNC患者的所有记录。搜索词包括各种HNC， RT，放化疗和锌补充排列。仅纳入介入研究，使用JBI偏倚风险工具进行质量评估。研究结果以叙述的方式综合。结果：纳入8项研究，涉及651例HNC患者，包括6项随机对照试验（rct）和2项非随机对照试验。研究中使用了各种放疗技术和同步化疗，锌以多种形式施用，包括糖浆、片剂、悬浮液、局部应用和漱口水。总的来说，六项研究报告了锌补充剂在降低OM的发病率、发病、持续时间和严重程度方面的有益作用，而两项研究报告没有显著影响。结论：锌补充剂可能由于其抗氧化、抗炎和伤口愈合的特性，在接受放疗和放化疗的HNC患者中显示出改善OM的希望。在这种情况下，需要进一步的研究来阐明锌补充的最佳剂量和方案。

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

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.