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The effects of zinc on radiation-induced dysgeusia: a systematic review and meta-analysis

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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.

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Data Availability

The data that support the findings of this study are available from the corresponding author, WJC, upon reasonable request.

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Acknowledgments

The authors thank Ann Sutton and Joe Munch in Scientific Publications in MD Anderson’s Research Medical Library for editing the manuscript and thank Research Medical Library staff for helping conduct literature searches.

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Authors and Affiliations

  1. Department of Hospital Dentistry, Walter Reed National Military Medical Center, Bethesda, MD, USA

    Woo J. Chi

  2. Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Jeffrey N. Myers & Mark S. Chambers

  3. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Steven J. Frank

  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

    Ruth A. Aponte-Wesson, Adegbenga O. Otun & Mark S. Chambers

  5. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Graciela M. Nogueras-González & Yisheng Li

  6. Research Medical Library, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Yimin Geng

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Appendix

Appendix

Ovid MEDLINE search strategy for radiation-induced dysgeusia

1 exp Radiotherapy

2 Radiotherap*.ti,ab,kf,fs.

3 Radiation/

4 exp radiation effects/

5 (radiation or irradiation* or irradiated).ti,ab,kf.

6 exp Radiotherapy Planning, Computer-Assisted/

7 (chemoradiation or "chemo-radiation" or "chemo-radiotherapy*" or chemoradiotherapy or radiochemo* or radio-chemo*).ti,ab,kf.

8 exp radiation dosage/

9 *radiation injuries/ or abnormalities, radiation-induced/

10 or/1-9

11 exp Taste Disorders/

12 exp Taste Perception/

13 Taste/ab, de, re [Abnormalities, Drug Effects, Radiation Effects]

14 Taste Buds/

15 Taste Threshold/

16 (dysgeusia* or parageusia* or ageusia* or hypogeusia*).ti,kf.

17 (taste adj5 (distort* or dysfunction* or disorder* or alter* or change* or abnormal* or blind* or impaired or impairment)).ti,kf.

18 (taste adj3 (loss* or acuity or damage* or disturbance* or sensation* or foul or aversion* or sense or sensitivity)).ti,kf.

19 (gustatory adj3 (perception* or sensitive* or distort*)).ti,ab,kf.

20 (taste or dysgeusia* or ageusia* or parageusia* or hypogeusia*).ab. /freq=2

21 or/11-20

22 10 and 21

23 limit 22 to english language

24 limit 23 to yr="2003 -Current"

25 (animals not (humans and animals)).sh.

26 24 not 25

27 (rat or rats or mouse or mice).ti.

28 26 not 27

29 case report*.pt,ti.

30 28 not 29

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Chi, W.J., Myers, J.N., Frank, S.J. et al. The effects of zinc on radiation-induced dysgeusia: a systematic review and meta-analysis. Support Care Cancer 28, 1–12 (2020). https://doi.org/10.1007/s00520-020-05578-8

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