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Systematic Review ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Oncol. | doi: 10.3389/fonc.2018.00484

Oral zinc sulfate for the prevention and treatment of chemotherapy-induced oral mucositis: a meta-analysis of 5 randomized controlled trials

 Xu Tian1, 2,  Xiao-Ling Liu1, Yuan-Ping Pi1, Hui Chen1 and  Wei-Qing Chen1*
  • 1Chongqing Cancer Hospital, China
  • 2TMR Publishing Group, China

Aims: Chemotherapy-induced oral mucositis is an extremely serious complication faced by cancer patients. The role of oral zinc sulfate in preventing and treating chemotherapy-induced oral mucositis remains debate.
Objectives: The aim of this systematic review is to assess the potential of oral zinc sulfate for this morbid condition.
Methods: A systematic search was conducted electronically in PubMed, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) to capture all potential randomized controlled trials investigating the efficacy and safety of oral zinc sulfate in prevention and treatment of chemotherapy-induced oral mucositis, and the retrieval time was limited from their inception to April 2018. We assigned 2 independent investigators to perform search, screen citations, extract information, and evaluate the risk of bias of all included trials. And then, RevMan 5.3 software was utilized to perform all statistical analyses.
Results: We included five eligible studies eventually, in which 352 patients were analyzed. Meta-analysis based on limited data revealed that oral zinc sulfate did not decrease the incidence of chemotherapy-induced oral mucositis (RR [relative risk] = 0.52, 95% CI [confidence interval] = 0.17 to 1.64) and not relieve the chemotherapy-induced oral mucositits grade (RR = 0.62, 95% CI = 0.11 to 3.56; RR = 0.70, 95% CI = 0.29 to 1.71). Moreover, qualitative analysis suggested that oral zinc sulfate can also not significantly reduce the oral pain intensity, delay onset of chemotherapy-induced oral mucositis, decrease adverse events and improve quality of life compared to control regimes.
Conclusions: Oral zinc sulfate may provide no clinical benefits in preventing or reducing the incidence, severity, and pain intensity in cancer patients. However, due to the presence of limitations, we still suggest designing further studies with large-scale and rigorous methods of addressing data to investigate the effects and safety of oral zinc sulfate for this pathologic condition.

Keywords: chemotherapy, Oral Mucositis, Zinc Sulfate, Systematic review, Meta-analysis

Received: 30 Jul 2018; Accepted: 09 Oct 2018.

Edited by:

Onder Alpdogan, Thomas Jefferson University, United States

Reviewed by:

Alejandro Majlis, Clinica Las Condes, Chile
Rehan Khan, Mayo Clinic, United States  

Copyright: © 2018 Tian, Liu, Pi, Chen and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Wei-Qing Chen, Chongqing Cancer Hospital, Chongqing, China,