Zinc supplementation to improve mucositis and dermatitis in patients after radiotherapy for head-and-neck cancers: A double-blind, randomized study

Lin, Li; Que, Jenny; Lin, Fong Chia

doi:10.1016/j.ijrobp.2006.01.015

Cited by 115 publications

(115 citation statements)

References 13 publications

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“…30 Zinc is another antioxidant, which was reported to prevent the occurrence of OM in patients with head and neck cancer who were undergoing radiotherapy. 10,31 However, our previous study revealed that zinc sulfate could not have any clinical benefits to the prevention of OM or reduction of its severity. 22 In a study by Jahangard-Rafsanjani et al 9 on the efficacy of selenium for the prevention of OM, selenium reduced the incidence and the duration of severe OM (grades 3-4).…”

Section: Discussionmentioning

confidence: 93%

N-acetyl cysteine for prevention of oral mucositis in hematopoietic SCT: a double-blind, randomized, placebo-controlled trial

Moslehi

Taghizadeh-Ghehi

Gholami

et al. 2014

Bone Marrow Transplant

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Oral mucositis (OM) is a complication of high-dose chemotherapy (HDC) which is frequently observed in hematopoietic SCT settings. Antioxidant agents have been proposed to prevent OM and therefore N-acetyl cysteine (NAC) could have an important role. In the present study, we conducted a double-blind, randomized, placebo-controlled study to evaluate the NAC effect on OM incidence and severity, and also glutathione peroxidase-1 activity. Leukemia patients undergoing allogeneic hematopoietic SCT preceded by HDC were recruited into the study and received either NAC (100 mg/kg/day) (n = 38) or placebo (n = 42) from the starting day of HDC until day +15 after transplantation. OM was evaluated daily for 21 days after transplantation according to World Health Organization oral toxicity scale. The incidence of severe OM (grades 3-4) was significantly lower in the NAC group (23.7% vs 45.3%, P = 0.04). Moreover, the mean duration of OM was significantly shorter in the intervention group (6.24(2.96) vs 8.12(3.97) days, P = 0.02). The glutathione peroxidase-1 activity was also significantly higher in the NAC group seven days after transplantation (3.38(2.19) vs 2.41(1.70) ng/mL, P = 0.003). It is concluded that parenteral NAC is effective in reducing the incidence of severe cases and the total duration of OM.

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Section: Discussionmentioning

confidence: 93%

N-acetyl cysteine for prevention of oral mucositis in hematopoietic SCT: a double-blind, randomized, placebo-controlled trial

Moslehi

Taghizadeh-Ghehi

Gholami

et al. 2014

Bone Marrow Transplant

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“…Twenty-six of the preventive trials were rcts 2,16-25, 27-32,34-37, [41][42][43][44]46 , six were nonrandomized clinical trials 3,26,33,38,39,45 , and one was a retrospective trial 40 . Twenty-one of the trials were open 3,16,19,20,24-26, 28,29,32-35,37-43,45 , three were single-blind 17,22,27 , and nine were double-blind 2,18,21,23,30,31,36,44,46 .…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-one of the trials were open 3,16,19,20,24-26, 28,29,32-35,37-43,45 , three were single-blind 17,22,27 , and nine were double-blind 2,18,21,23,30,31,36,44,46 . Of the six management trials, three were rcts 49,50,52 , and three were nonrandomized clinical trials 47,48,51 .…”

Section: Resultsmentioning

confidence: 99%

Prophylaxis and Management of Acute Radiation-Induced Skin Reactions: A Systematic Review of the Literature

et al. 2010

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Radiation therapy is a common treatment for cancer patients. One of the most common side effects of radiation is acute skin reaction (radiation dermatitis) that ranges from a mild rash to severe ulceration. Approximately 85% of patients treated with radiation therapy will experience a moderate-to-severe skin reaction. Acute radiation-induced skin reactions often lead to itching and pain, delays in treatment, and diminished aesthetic appearance-and subsequently to a decrease in quality of life.Surveys have demonstrated that a wide variety of topical, oral, and intravenous agents are used to prevent or to treat radiation-induced skin reactions. We conducted a literature review to identify trials that investigated products for the prophylaxis and management of acute radiation dermatitis. Thirty-nine studies met the pre-defined criteria, with thirty-three being categorized as prophylactic trials and six as management trials.For objective evaluation of skin reactions, the Radiation Therapy Oncology Group criteria and the U.S. National Cancer Institute Common Toxicity Criteria were the most commonly used tools (65% of the studies). Topical corticosteroid agents were found to significantly reduce the severity of skin reactions; however, the trials of corticosteroids evaluated various agents, and no clear indication about a preferred corticosteroid has emerged. Amifostine and oral enzymes were somewhat effective in preventing radiation-induced skin reactions in phase ii and phase iii trials respectively; further large randomized controlled trials should be undertaken to better investigate those products. Biafine cream (Ortho-McNeil Pharmaceuticals, Titusville, NJ, U.S.A.) was found not to be superior to standard regimes in the prevention of radiation-induced skin reactions (n = 6).In conclusion, the evidence is insufficient to support the use of a particular agent for the prevention and management of acute radiation-induced skin reactions. Future trials should focus on comparing agents and approaches that, in phase i and ii trials, suggest efficacy. These future phase iii randomized controlled trials must clearly distinguish between preventive and management strategies for radiation-induced dermatitis. Only then can evidence-based guidelines be developed, with the hope of standardizing the approach across centres and of improving the prevention and management of radiation-induced dermatitis.

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“…Zinc supplementation, 25 mg given three times a day during radiation therapy, delayed the development of grade 2 and reduced the number of grade 3 mucositis in a group of 50 head and neck cancer patients [126]. Concurrent administration of chemotherapy decreased the degree of benefit observed.…”

Section: Stomatitis/mucositismentioning

confidence: 95%

“…Lower incidence of new disease, new metastases, or death; increased time to relapse [102,103] Probiotics in biliary cancer patients undergoing surgery; colorectal cancer patients undergoing chemotherapy; patients receiving abdominal and pelvic radiation Lower postoperative infection rates; decreased gastrointestinal toxicity (diarrhea) with less hospital care and less reduction in chemotherapy; decreased incidence of diarrhea [106,[143][144][145][146] Glutamine in variety of cancer patients undergoing chemotherapy and radiation Decreased rates and severity of mucositis, neuropathy, and intestinal toxicity; decreased use of pain medication in stomatitis patients; improved nutrition in stomatitis patients; improved ADL in neuropathy patients [112-119, 137-139, 148-150] Vitamin E topically in children undergoing bone marrow transplant; in adults undergoing chemotherapy or radiation to head and neck area Improved stomatitis [122,124,125] Zinc in head and neck patients during radiation therapy Improved stomatitis [126,127] (continued on next page) Chamomile extract as mouthwash in chemotherapy and radiation Improved stomatits sometimes [129,130] Homeopathic remedy including Arnica montana in chemotherapy Improved stomatitis [132] Proteolytic enzymes in head and neck patients with radiation…”

Section: Grifola Umbellatae In Bladder Cancermentioning

confidence: 99%

Dietary Supplement Use in Cancer Care: Help or Harm

Hardy

2008

Hematology/Oncology Clinics of North America

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Zinc supplementation to improve mucositis and dermatitis in patients after radiotherapy for head-and-neck cancers: A double-blind, randomized study

Cited by 115 publications

References 13 publications

N-acetyl cysteine for prevention of oral mucositis in hematopoietic SCT: a double-blind, randomized, placebo-controlled trial

N-acetyl cysteine for prevention of oral mucositis in hematopoietic SCT: a double-blind, randomized, placebo-controlled trial

Prophylaxis and Management of Acute Radiation-Induced Skin Reactions: A Systematic Review of the Literature

Dietary Supplement Use in Cancer Care: Help or Harm

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