A Randomized Double-Blind, Placebo-Controlled Trial
of Zinc Sulfate Supplementation for Alleviation of
Radiation-Induced Oral Mucositis and Pharyngitis
in Head and Neck Cancer Patients
Duangjai Sangthawan MD*,
Temsak Phungrassami MD*, Wattana Sinkitjarurnchai MD**
Affiliation :
* Division of Radiation Oncology, Department of Radiology, Faculty of Medicine,
Prince of Songkla University, Songkhla, Thailand
** Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine,
Prince of Songkla University, Songkhla, Thailand
Objective : To determine the efficacy of zinc sulfate supplementation in reducing of radiation-induced oral mucositis and
pharyngitis in head and neck cancer patients.
Material and Method: One hundred forty four head and neck patients were enrolled in a randomized, double-blind, placebo-
controlled trial. Patients who received radiation therapy alone or postoperative radiation therapy were eligible. Radiation
therapy used conventional fractionation with 1.8 to 2.0 Gy per fraction, to total doses of 50 to 70 Gy over five to seven
weeks. Drug and identically appearing placebo were self-administered 50 mg (10 cc) per meal, three times a day at mealtime.
The zinc sulfate and placebo were administered beginning on the first day of radiation, and continued daily including
weekends until radiation was completed. Patients were evaluated before radiation, weekly during radiation and at the first
month after completion of radiation.
Results : The baseline characteristics of patients, tumor, and treatment were not significantly different between the two
groups. There were no statistically significant differences between the two treatment groups in frequency of patients
experiencing greater than or equal to grade 2 oral mucositis and pharyngitis at each week during radiation and at the first
month after completion of radiation. Six patients (17%) in the zinc sulfate and ten patients (23%) in placebo group developed
grade 3 oral mucositis, which was not significantly different. Twenty-two patients (32%) in the zinc sulfate and nineteen
patients (27%) in the placebo group developed grade 3 pharyngitis, which was not significantly different. However, there
was no observation of grade 4 oral mucositis and pharyngitis in either group. Nausea and vomiting were mostly of mild
degree. Adverse events were not statistically significant different between the two groups.
Conclusion : It was concluded that zinc sulfate administered during head and neck radiation therapy produced no significant
benefit in relieving radiation-induced oral mucositis and pharyngitis with acceptable side effects.
Keywords : Zinc sulfate, Oral mucositis, Pharyngitis, Radiation therapy, Head and neck cancer
All Articles
Download