Background:
Oral mucositis is an inevitable and distressing adverse event patients, who were treated with irradiation for
head and neck cancer, face. Although several studies have investigated the potential of oral
zinc sulfate in preventing radiation-induced
oral mucositis in patients with head and
neck cancers, conclusive results have not yet been found. Objective: The aim of the present study is to determine whether oral
zinc sulfate is effective in preventing radiation-induced
oral mucositis, in patients with head and
neck cancers. Methods: We electronically searched all potential citations in PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL) and EBSCO from their inception to December 2018. After the search and checked literatures, extracted data and appraised risk of bias, RevMan software version 5.3 was used to perform meta-analysis. Results: Four randomized controlled trials (RCTs) involving 162 patients were included. A meta-analysis showed that
zinc sulfate did not decrease the incidence (RR [relative risk], 0.97; 95% CI [confidence interval], 0.74-1.28), and did not relieve the moderate and severe grade of radiation induced
oral mucositis (moderate and severe
oral mucositis: RR, 0.84; 95% CI, 0.14-4.87; severe
oral mucositis: RR, 0.43; 95% CI, 0.00-38.98). A qualitative analysis suggested that
zinc sulfate was associated with the onset of
oral mucositis. Conclusions: Based on limited evidence,
zinc sulfate may not have the benefit of prophylaxis against radiation-induced
oral mucositis, in patients with head and
neck cancers. However, further RCTs with larger sample sizes and more rigorous methodologies are needed to enhance the evidence of these results.