Abstract
PurposeDysgeusia is an adverse event caused by chemotherapy. Although retrospective studies have shown zinc administration improves dysgeusia, there have been no prospective studies. The present study examined effects of zinc therapy on dysgeusia in patients with gastrointestinal cancer.MethodsThis multicenter, prospective, observational study enrolled patients with dysgeusia during chemotherapy treatment. Patients received no intervention (control), polaprezinc p.o., or zinc acetate hydrate p.o., and serum zinc levels were measured at 0 (baseline), 6, and 12 weeks. Dysgeusia was assessed using CTCAE v5.0 and subjective total taste acuity (STTA) criteria using questionnaires at baseline and 12 weeks.ResultsFrom February 2020 to June 2021, 180 patients were enrolled from 17 institutes. There were no differences in mean baseline serum zinc levels among the groups (67.3, 66.6, and 67.5 μg/dL in the no intervention, polaprezinc, and zinc acetate hydrate groups, respectively. P = 0.846). The changes in mean serum zinc levels after 12 weeks were − 3.8, + 14.3, and + 46.6 μg/dL, and the efficacy rates of dysgeusia were 33.3%, 36.8%, and 34.6% using CTCAE and 33.3%, 52.6%, 32.7% using STTA in the no intervention, polaprezinc, and zinc acetate hydrate groups, respectively. The STTA scores improved in all groups, with significant improvement observed in the polaprezinc group compared with the no intervention group (P = 0.045).ConclusionThere was no significant correlation between the degree of serum zinc elevation and improvement in dysgeusia, suggesting that polaprezinc, but not zinc acetate hydrate, was effective in improving chemotherapy-induced dysgeusia.Trial registration.UMIN000039653. Date of registration: March 2, 2020.
Highlights
The development of antitumor agents and overall survival in gastrointestinal cancer patients has dramatically improved in the last decade
Among a total of 180 patients enrolled in the study, five were excluded due to noncompliance with the participation criteria, and three patients in the no intervention group began receiving zinc therapy
The mean serum zinc levels at baseline were 67.3 μg/dL (95% confidence interval (CI), 63.0–71.6 μg/dL) in the no intervention group, 67.5 μg/ dL in the zinc acetate hydrate
Summary
The development of antitumor agents and overall survival in gastrointestinal cancer patients has dramatically improved in the last decade. Quality of life (QOL), and management of adverse events has become increasingly important. Diet is an important factor in QOL maintenance, but adverse events of chemotherapy including. Extended author information available on the last page of the article anorexia, nausea, vomiting, and dysgeusia reduce oral intake [1–4]. Prevention and treatment have been established for chemotherapy-induced nausea, vomiting, and oral mucositis, there is currently no successful intervention for dysgeusia [5, 6]. The incidence of chemotherapy-induced dysgeusia is around 30–85% [7–17], with moderate-tosevere cases occurring in around 38% of patients [10, 12]. Fluoropyrimidines and platinum-based drugs, which are often used for gastrointestinal cancers, cause dysgeusia in 48.1% and 42.1% of patients, respectively [16].
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