锌制剂治疗头颈部肿瘤放射性口腔黏膜炎疗效的Meta分析

目的:系统评价锌制剂治疗头颈部肿瘤放射性口腔黏膜炎的疗效,为临床治疗提供循证参考。方法:计算机检索PubMed、Medline、Embase、Cochrane图书馆、中国期刊全文数据库、维普网、万方数据,检索时限均为建库起至2018年12月,收集在常规治疗或空白对照(对照组)的基础上加用锌制剂(试验组)治疗头颈部肿瘤放射性口腔黏膜炎疗效的随机对照试验(RCT),对符合纳入标准的临床研究进行资料提取,并采用Cochrane系统评价员手册5.1.0进行质量评价后,采用Rev Man 5.3统计软件对给药后2 周放射性口腔黏膜炎发生率、放射性口腔黏膜炎总发生率、严重放射性口腔黏膜炎发生率进行Meta分析。结果:共纳入8项RCT,合计550例患者。Meta分析结果显示,两组患者2周放射性口腔黏膜炎发生率[OR=0.55,95%CI(0.26,1.17),P=0.12]、放射性口腔黏膜炎总发生率[OR=0.59,95%CI(0.08,4.39),P=0.60]及严重放射性口腔黏膜炎发生率[OR=0.58,95%CI(0.23,1.47),P=0.25]比较差异均无统计学意义。结论:在常规治疗或空白对照的基础上加用锌制剂不能降低头颈部肿瘤放射性口腔黏膜炎发生率及控制疾病发展。

Efficacy of Zinc Preparation for Radiation-induced Oral Mucositis in Head and Neck Cancers:A Meta-analysis

OBJECTIVE: To systematically evaluate therapeutic efficacy of Zinc preparation for radiation-induced oral mucositis(ROM)in head and neck cancers,and to provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,Medline,Embase,the Cochrane library,CJFD,VIP and Wanfang database,RCTs about additional use of Zinc preparation(trial group)in adjunctive treatment of ROM in head and neck cancers base on routine treatment or blank control (control group) were collected during database establishment to Dec. 2018. After data extraction and quality evaluation with Cochrane system evaluator manual 5.1.0,Meta-analysis was carried out for the incidence of ROM within 2 weeks after medication, total incidence of ROM and the incidence of serve ROM by using Rev Man 5.3 statistical software. RESULTS:A total of 8 RCTs were included,involving 550 patients. Results of Meta-analysis showed that there was no statistical significance in the incidence of ROM within 2 weeks [OR=0.55,95%CI(0.26,1.17),P=0.12],total incidence of ROM [OR=0.59,95%CI(0.08,4.39),P= 0.60] or the incidence of serve ROM [OR=0.58,95%CI(0.23,1.47),P=0.25] between 2 group. CONCLUSIONS:Based on routine therapy or blank control,additional use of Zinc preparation can not reduce the incidence and control the development of ROM in head and neck cancers.