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

Stefane Caroline Carvalho Moura E Vasconcelos, Eliete Neves Silva Guerra, Amanda Gomes de Menêses, Paula Elaine Diniz Dos Reis, Elaine Barros Ferreira

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 2023 Mar 28

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To evaluate the effectiveness and safety of oral supplementation as a radioprotective intervention in the management of radiation dermatitis (RD). 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. 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. 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. © 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Citation

Stefane Caroline Carvalho Moura E Vasconcelos, Eliete Neves Silva Guerra, Amanda Gomes de Menêses, Paula Elaine Diniz Dos Reis, Elaine Barros Ferreira. Effects of oral supplementation to manage radiation dermatitis in cancer patients: a systematic review. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2023 Mar 28;31(4):240