Ruo-Zhu Tai1, El-Wui Loh2,3,4,5, Jo-Ting Tsai6,7, Ka-Wai Tam8,9,10,11. 1. School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. 2. Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. 3. Department of Dentistry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan. 4. Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan. 5. Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan. 6. Department of Radiation Oncology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan. 7. Department of Radiation Oncology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. 8. Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan. kelvintam@h.tmu.edu.tw. 9. Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan. kelvintam@h.tmu.edu.tw. 10. Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, 291, Zhongzheng Road, Zhonghe District, New Taipei City, 23561, Taiwan. kelvintam@h.tmu.edu.tw. 11. Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. kelvintam@h.tmu.edu.tw.
Abstract
PURPOSE: Radiotherapy (RT)-induced mucocutaneous side effects remain a clinical challenge in cancer patients. Hyaluronic acid (HA), a key molecule in tissue regeneration, may relieve these side effects. The aim of the study is to investigate the effects of HA on RT-induced side effects in patients with cancer. METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) was carried out. PubMed, Embase, and Cochrane Library were searched for published studies. A meta-analysis was conducted to calculate the pooled effect size using a random-effect model. RESULTS: Fifteen trials with 1131 patients were included. The HA group demonstrated a significant improvement in skin pain scores (mean difference [MD]: - 1.14, 95% confidence interval [CI]: - 2.21 to - 0.08) at week 4, and significantly decreased pain frequency (risk ratio [RR]: 0.47, 95% CI: 0.24 to 0.93) at 5 to 8 weeks when compared with the control group. The HA group also exhibited a significantly lower incidence of desquamation (RR: 0.27, 95% CI: 0.15 to 0.5) at 4 to 5 weeks and the most severe mucosal problems (RR: 0.14, 95% CI: 0.04 to 0.45) compared with the control group. Moreover, the HA group had a significantly lower incidence of bleeding (RR: 0.18, 95% CI: 0.05 to 0.65) than the control group at 4 months and 18 months. CONCLUSION: HA treatment may reduce RT-induced mucosal problems and pain. Moreover, HA is safe and has the potential for application in diverse forms and textures for pharmacotherapeutic use. Additional trials involving a higher number of patients are recommended.
PURPOSE: Radiotherapy (RT)-induced mucocutaneous side effects remain a clinical challenge in cancer patients. Hyaluronic acid (HA), a key molecule in tissue regeneration, may relieve these side effects. The aim of the study is to investigate the effects of HA on RT-induced side effects in patients with cancer. METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) was carried out. PubMed, Embase, and Cochrane Library were searched for published studies. A meta-analysis was conducted to calculate the pooled effect size using a random-effect model. RESULTS: Fifteen trials with 1131 patients were included. The HA group demonstrated a significant improvement in skin pain scores (mean difference [MD]: - 1.14, 95% confidence interval [CI]: - 2.21 to - 0.08) at week 4, and significantly decreased pain frequency (risk ratio [RR]: 0.47, 95% CI: 0.24 to 0.93) at 5 to 8 weeks when compared with the control group. The HA group also exhibited a significantly lower incidence of desquamation (RR: 0.27, 95% CI: 0.15 to 0.5) at 4 to 5 weeks and the most severe mucosal problems (RR: 0.14, 95% CI: 0.04 to 0.45) compared with the control group. Moreover, the HA group had a significantly lower incidence of bleeding (RR: 0.18, 95% CI: 0.05 to 0.65) than the control group at 4 months and 18 months. CONCLUSION: HA treatment may reduce RT-induced mucosal problems and pain. Moreover, HA is safe and has the potential for application in diverse forms and textures for pharmacotherapeutic use. Additional trials involving a higher number of patients are recommended.
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