Woo J Chi1, Jeffrey N Myers2, Steven J Frank3, Ruth A Aponte-Wesson4, Adegbenga O Otun4, Graciela M Nogueras-González5, Yisheng Li5, Yimin Geng6, Mark S Chambers7,8. 1. Department of Hospital Dentistry, Walter Reed National Military Medical Center, Bethesda, MD, USA. amoschi@gmail.com. 2. Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 3. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 4. Section of Oral Oncology and Maxillofacial Prosthodontics, Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 5. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 6. Research Medical Library, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 7. Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. mchamber@mdanderson.org. 8. Section of Oral Oncology and Maxillofacial Prosthodontics, Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. mchamber@mdanderson.org.
Abstract
PURPOSE: Many head and neck cancer patients who receive radiation therapy experience radiation-induced dysgeusia (RID), which has no standard treatment. The only supplement controlled clinical trials have evaluated for the treatment of RID is zinc. However, the results of these and other studies investigating the use of zinc for RID have been inconsistent. To assess the validity of zinc as a treatment for RID, we conducted a systematic literature search and performed a meta-analysis to determine the extent to which zinc affects RID incidence and the degree to which ongoing RID responds to zinc. METHODS: We searched the Ovid MEDLINE, Ovid Embase, PubMed, and Cochrane Library databases to identify studies investigating the use of zinc-based therapy for RID in head and neck cancer patients treated with radiation that were published between January 1, 2003, and November 9, 2017. Using American Society of Clinical Oncology criteria, we selected studies with a high level of evidence for inclusion in the meta-analysis. RESULTS: Of the 32 full-text articles eligible for inclusion, three were included in the final review and meta-analysis. The meta-analysis showed that, compared with placebo, zinc reduces the incidence of RID (risk ratio, 0.72; 95% confidence interval, 0.67-0.92) but does not improve taste acuity more rapidly following radiation therapy (risk ratio, 2.58; 95% confidence interval, 0.97-6.88). CONCLUSION: Our findings indicate that zinc-based therapy reduces the incidence of RID but has a minimal effect on ongoing RID. Our findings also highlight the need for additional evidence-based research on this topic.
PURPOSE: Many head and neck cancerpatients who receive radiation therapy experience radiation-induced dysgeusia (RID), which has no standard treatment. The only supplement controlled clinical trials have evaluated for the treatment of RID is zinc. However, the results of these and other studies investigating the use of zinc for RID have been inconsistent. To assess the validity of zinc as a treatment for RID, we conducted a systematic literature search and performed a meta-analysis to determine the extent to which zinc affects RID incidence and the degree to which ongoing RID responds to zinc. METHODS: We searched the Ovid MEDLINE, Ovid Embase, PubMed, and Cochrane Library databases to identify studies investigating the use of zinc-based therapy for RID in head and neck cancerpatients treated with radiation that were published between January 1, 2003, and November 9, 2017. Using American Society of Clinical Oncology criteria, we selected studies with a high level of evidence for inclusion in the meta-analysis. RESULTS: Of the 32 full-text articles eligible for inclusion, three were included in the final review and meta-analysis. The meta-analysis showed that, compared with placebo, zinc reduces the incidence of RID (risk ratio, 0.72; 95% confidence interval, 0.67-0.92) but does not improve taste acuity more rapidly following radiation therapy (risk ratio, 2.58; 95% confidence interval, 0.97-6.88). CONCLUSION: Our findings indicate that zinc-based therapy reduces the incidence of RID but has a minimal effect on ongoing RID. Our findings also highlight the need for additional evidence-based research on this topic.
Authors: Glenn J Lesser; Megan B Irby; Richard C Taylor; Anna Snavely; Douglas Case; Aili Wang; Andrea Dietrich; Susan Duncan Journal: Support Care Cancer Date: 2021-10-13 Impact factor: 3.359