Effectiveness of vitamin E on oral mucositis caused by radiotherapy and chemotherapy: a meta-analysis

doi:10.3969/j.issn.1674-8115.2023.02.010

Abstract

Abstract:

Objective ·To examine, using a systematic review and meta-analysis, the effectiveness of vitamin E on treating oral mucositis caused by radiotherapy and chemotherapy. Methods ·A systematic literature search was performed by using PubMed, Embase, Cochrane Library, Web of Science, CINAHL, OpenGrey, Chinese biomedical literature database (CBM), Chinese national knowledge infrastructure (CNKI), Wanfang Data, and China Science and Technology Journal Database (VIP). The retrieval time was up to March 2022. The risk of bias was assessed by using the Cochrane Risk-of-Bias tool, version 2.0. RevMan 5.4 was used for meta-analysis. Results ·A total of 563 literatures were retrieved. A total of 7 randomized controlled trials were included. The results of meta-analysis revealed that vitamin E supplementation did not significantly affect oral mucositis caused by chemoradiotherapy (RR=0.44, 95%CI 0.15?1.25, Z=1.54, P=0.120). However, vitamin E may have some effect on severe oral mucositis (RR=0.22, 95%CI 0.11?0.43, Z=4.33, P=0.000). Conclusion ·It cannot be explained that vitamin E can effectively treat oral mucositis caused by radiotherapy and chemotherapy, but vitamin E may be effective for severe oral mucositis.

Key words: vitamin E, oral mucositis, randomized controlled trial, meta analysis

CLC Number:

R730.6

LIANG Yanjing, HUANG Chuxian, LI Hongyan, HOU Lili. Effectiveness of vitamin E on oral mucositis caused by radiotherapy and chemotherapy: a meta-analysis[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(2): 208-214.

Figures/Tables 4

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References 28

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Study （year）	Study design	Country	Population	No. of patients （T/C）	Extracted data （T/C）	Intervention		Intervention Content	Outcome
Study （year）	Study design	Country	Population	No. of patients （T/C）	Extracted data （T/C）	T	C	Intervention Content	Outcome
SAYED, et al.,2020^［14］	RCT	Egypt	Head and neck cancer	30/30	22/25	a+b+c	a	T: Vitamin E （oral soft gelatin capsules） 1 000 mg once daily + pentoxifylline （oral tablets） 400 mg twice daily for 6 to 7 weeks C: Blank control for 6 to 7 weeks	①②③ ④⑧
KHURANA, et al., 2013^［15］	RCT	India	Hematological cancer	24/24/24	24/24	a+b+d	a+d	T: Vitamin E （prepared by using the same vehicle as the control group） 200 mg daily for a week C: Vehicle （glycerine plus water in a 1∶1 ratio） for a week	①②③④
LI, et al., 2007^［16］	RCT	China	Nasopharyngeal cancer	30/30	30/30	a+b+h+i	a	T: Vitamin E one tablet daily + compound vitamin B two tablets 3 times a day + Gene time spray 2 to 4 times a day C: Routine oral care	①②③
LIN, 2005^［17］	RCT	China	General cancer	80/80	80/80	a+b	a+k	T: Using a sterile needle to puncture the ulcer， and applying a cotton swab dipped in vitamin E to the affected area after meals or before bedtime C: Rinsing the mouth with 2% boric acid solution for 5 to 10 minutes 3 to 6 times a day	①④
FERREIRA, et al., 2004^［18］	RCT	Brazil	Head and neck cancer	28/26	167/161	a+b	a+g	T: Vitamin E （oral capsule） 400 mg from the first to the last day of radiotherapy C: Placebo （oral Efamol Pure Evening Primrose Oil） 500 mg from the first to the last day of radiotherapy	①③④⑤⑥⑦
ZHU, et al.,1994^［19］	RCT	China	General cancer	14/14	18/21	a+b	a+f+j	T: Vitamin E （topically） 10 mg twice daily for a week C: Vitamin B2 （orally） 10 mg 3 times a day for a week	③
WADLEIGH, et al., 1992^［7］	RCT	USA	General cancer	9/9	9/9	a+b	a+g	T: Vitamin E （topically） 400 mg twice daily for 5 d C: Placebo （coconut and soybean oil containing less than 1 mg of vitamin E） twice daily for 5 d	①③⑨

Study （year）	Study design	Country	Population	No. of patients （T/C）	Extracted data （T/C）	Intervention		Intervention Content	Outcome
Study （year）	Study design	Country	Population	No. of patients （T/C）	Extracted data （T/C）	T	C	Intervention Content	Outcome
SAYED, et al.,2020^［14］	RCT	Egypt	Head and neck cancer	30/30	22/25	a+b+c	a	T: Vitamin E （oral soft gelatin capsules） 1 000 mg once daily + pentoxifylline （oral tablets） 400 mg twice daily for 6 to 7 weeks C: Blank control for 6 to 7 weeks	①②③ ④⑧
KHURANA, et al., 2013^［15］	RCT	India	Hematological cancer	24/24/24	24/24	a+b+d	a+d	T: Vitamin E （prepared by using the same vehicle as the control group） 200 mg daily for a week C: Vehicle （glycerine plus water in a 1∶1 ratio） for a week	①②③④
LI, et al., 2007^［16］	RCT	China	Nasopharyngeal cancer	30/30	30/30	a+b+h+i	a	T: Vitamin E one tablet daily + compound vitamin B two tablets 3 times a day + Gene time spray 2 to 4 times a day C: Routine oral care	①②③
LIN, 2005^［17］	RCT	China	General cancer	80/80	80/80	a+b	a+k	T: Using a sterile needle to puncture the ulcer， and applying a cotton swab dipped in vitamin E to the affected area after meals or before bedtime C: Rinsing the mouth with 2% boric acid solution for 5 to 10 minutes 3 to 6 times a day	①④
FERREIRA, et al., 2004^［18］	RCT	Brazil	Head and neck cancer	28/26	167/161	a+b	a+g	T: Vitamin E （oral capsule） 400 mg from the first to the last day of radiotherapy C: Placebo （oral Efamol Pure Evening Primrose Oil） 500 mg from the first to the last day of radiotherapy	①③④⑤⑥⑦
ZHU, et al.,1994^［19］	RCT	China	General cancer	14/14	18/21	a+b	a+f+j	T: Vitamin E （topically） 10 mg twice daily for a week C: Vitamin B2 （orally） 10 mg 3 times a day for a week	③
WADLEIGH, et al., 1992^［7］	RCT	USA	General cancer	9/9	9/9	a+b	a+g	T: Vitamin E （topically） 400 mg twice daily for 5 d C: Placebo （coconut and soybean oil containing less than 1 mg of vitamin E） twice daily for 5 d	①③⑨

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