Polaprezinc reduces the severity of radiation-induced mucositis in head and neck cancer patients

Abstract

Abstract. Polaprezinc (PZ), an antiulcer drug, has been reported to have antioxidant properties. The aim of the present study was to assess the feasibility and efficacy of administering PZ for radiation-induced mucositis in head and neck cancer patients. Patients with newly diagnosed head and neck cancer were enrolled in this prospective study. PZ was prepared as an oral rinse. The PZ oral rinse was used four times per day during the course of radiotherapy. Sequential changes in radiation mucositis were assessed during and after radiotherapy according to the Common Terminology Criteria for Adverse Events, version 3.0. Furthermore, a retrospective comparison analysis was performed to assess the efficacy of PZ for radiation-induced mucositis. A total of 32 patients were enrolled in the prospective study of the PZ oral rinse. Radiotherapy was performed up to a total dose of 60-66 Gy using a conventional schedule combined with chemotherapy. Of the 32 patients, 30 (93.8%) reported no complaints due to the PZ oral rinse. In addition, PZ was not associated with severe adverse effects. Among the patients who received PZ, grade 3 mucositis was observed in 29.0% based on the mucosal findings and in 39.3% based on the symptoms. In the patients who did not receive PZ, the incidence of grade 3 mucositis was 40.0% based on the mucosal findings and 60.7% based on the symptoms. Moreover, PZ promoted the recovery from mucositis caused by chemoradiotherapy and was not associated with reduced tumor response to radiotherapy. Therefore, the PZ oral rinse was well tolerated and proved to be efficient for the treatment of radiotherapy-induced oral mucositis.

Systematic review of natural and miscellaneous agents for the management of oral mucositis in cancer patients and clinical practice guidelines—part 1: vitamins, minerals, and nutritional supplements

“…The efficacy of systemic zinc in preventing OM in H&N cancer patients was also evaluated in 2 case-control studies demonstrating conflicting results [11,12].…”

Polaprezinc protects normal intestinal epithelium against exposure to ionizing radiation in mice

“…Our previous study reported the efficacy of PZ for acute radiation proctitis in a rat model and demonstrated the anti-inflammatory effect of PZ on radiation-induced mucosal damage ( 6 ). In addition, the clinical use of PZ has been reported to be feasible and can increase a patient's QOL during radiotherapy ( 8 , 9 ).…”

“…There is, however, little data of the negative effects of PZ use for tumor control and the survival outcomes of the patients who received PZ as a supportive treatment have been poorly understood. However, no direct evidence has suggested that the use of PZ can lead to inferior tumor outcomes in patients with malignancies ( 8 , 9 ). Watanabe et al ( 8 ) reported that the initial responses of tumors to radiotherapy were not affected by the PZ intake in a randomized clinical trial.…”

“…Our previous study reported the efficacy of PZ for acute radiation proctitis in an animal model and demonstrated that PZ has an anti-inflammatory effect following exposure to radiation ( 6 ). However, the radioprotective effects of PZ have been reported in only a limited number of reports and remain unclear ( 6 – 9 ).…”

Polaprezinc inhibits liver fibrosis and proliferation in hepatocellular carcinoma

“…Polaprezinc, a zinc complex of L-carnosine, is widely used as a gastric mucosal protector to treat gastric ulcers and a previous study revealed it may inhibit liver fibrosis in mice (20). Although, it was believed that HSCs are involved in polaprezinc-induced reversal of liver fibrosis, more evidence is required to confirm this hypothesis.…”