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Effects of oral supplementation to manage radiation dermatitis in cancer patients: a systematic review

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Abstract

Purpose

To evaluate the effectiveness and safety of oral supplementation as a radioprotective intervention in the management of radiation dermatitis (RD).

Methods

Systematic review and meta-analysis. Six databases and the gray literature were searched for randomized controlled clinical trials (RCTs). Meta-analysis was performed only with studies that evaluated the same intervention. Methodology of included studies was evaluated by the Cochrane risk-of-bias tool for randomized trials (RoB 2.0), and the certainty of evidence was assessed by the GRADE instrument.

Results

Seventeen RCTs were included in this review. These evaluated different types of oral supplementations. Findings from three meta-analyses demonstrated no significant benefits to the more severe grades of RD, as oral curcuminoids (RR, 0.59; 95% CI, 0.27 to 1.29; P = 0.19; I2 = 88%), glutamine (RR, 0.40; 95% CI, 0.15 to 1.03; P = 0.06; I2 = 78%) or Wobe-Mugos (RR, 0.57; 95% CI, 0.29 to 1.14; P = 0.11; I2 = 72%). Also, the certainty of the evidence of outcomes evaluated was moderate or low. Except for a few gastrointestinal adverse events, oral supplementation was well tolerated.

Conclusion

Most oral supplements cannot yet be recommended to manage RD due to insufficient or conflicting evidence. However, despite no significant results, glutamine was shown to be a promising substance in terms of the potential radioprotective effect and may be well tolerated. These results suggest that more RCTs with larger samples are needed to evaluate the efficacy, safety, and tolerance of glutamine in the management of RD.

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Fig. 1

Adapted from PRISMA (Page et al., 2021)

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Data Availability

Not applicable.

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Funding

The first author received financial support for the research in the Nursing Graduate Program at the University of Brasília, Brazil. The Program had no role in the study design and interpretation of results. This research did not receive funding from agencies.

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Authors and Affiliations

  1. Nursing Graduate Program, School of Health Sciences, University of Brasília, Brasília, DF, Brazil

    Stefane Caroline Carvalho Moura e Vasconcelos & Amanda Gomes de Menêses

  2. Laboratory of Oral Histopathology, School of Health Sciences, University of Brasília, Brasília, DF, Brazil

    Eliete Neves Silva Guerra

  3. Nursing Department, School of Health Sciences, University of Brasília, Campus Darcy Ribeiro, Asa Norte, Brasília, DF, 70910-900, Brazil

    Paula Elaine Diniz dos Reis & Elaine Barros Ferreira

Authors
  1. Stefane Caroline Carvalho Moura e Vasconcelos
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  2. Eliete Neves Silva Guerra
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  3. Amanda Gomes de Menêses
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  4. Paula Elaine Diniz dos Reis
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  5. Elaine Barros Ferreira
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by S.C.C.M.V, E.B.F., A.G.M., E.N.S.G. and P.E.D.R. The first draft of the manuscript was written by S.C.C.M.V and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Elaine Barros Ferreira.

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e Vasconcelos, S.C.C.M., Guerra, E.N.S., de Menêses, A.G. et al. Effects of oral supplementation to manage radiation dermatitis in cancer patients: a systematic review. Support Care Cancer 31, 240 (2023). https://doi.org/10.1007/s00520-023-07685-8

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