Does zinc sulfate prevent therapy-induced taste alterations in head and neck cancer patients? Results of phase III double-blind, placebo-controlled trial from the North Central Cancer Treatment Group (N01C4).

Abstract

PURPOSE:

Taste alterations (dysgeusia) are well described in head and neck cancer patients who undergo radiotherapy (RT). Anecdotal observations and pilot studies have suggested zinc may mitigate these symptoms. This multi-institutional, double-blind, placebo-controlled trial was conducted to provide definitive evidence of this mineral's palliative efficacy.

METHODS AND MATERIALS:

A total of 169 evaluable patients were randomly assigned to zinc sulfate 45 mg orally three times daily vs. placebo. Treatment was to be given throughout RT and for 1 month after. All patients were scheduled to receive > or =2,000 cGy of external beam RT to > or =30% of the oral cavity, were able to take oral medication, and had no oral thrush at study entry. Changes in taste were assessed using the previously validated Wickham questionnaire.

RESULTS:

At baseline, the groups were comparable in age, gender, and planned radiation dose (<6,000 vs. > or =6,000 cGy). Overall, 61 zinc-treated (73%) and 71 placebo-exposed (84%) patients described taste alterations during the first 2 months (p = 0.16). The median interval to taste alterations was 2.3 vs. 1.6 weeks in the zinc-treated and placebo-exposed patients, respectively (p = 0.09). The reported taste alterations included the absence of any taste (16%), bitter taste (8%), salty taste (5%), sour taste (4%), sweet taste (5%), and the presence of a metallic taste (10%), as well as other descriptions provided by a write in response (81%). Zinc sulfate did not favorably affect the interval to taste recovery.

CONCLUSION:

Zinc sulfate, as prescribed in this trial, did not prevent taste alterations in cancer patients who were undergoing RT to the oral pharynx.

• Authors: Michele Y Halyard, Aminah Jatoi, Jeff A Sloan, James D Bearden 3rd, Sujay A Vora, Pamela J Atherton, Edith A Perez, Gammi Soori, Anthony C Zalduendo, Angela Zhu, Philip J Stella, Charles L Loprinzi
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 67 Issue 5 Pg. 1318-22 (Apr 01 2007) ISSN: 0360-3016 [Print] United States
• PMID: 17394940 (Publication Type: Clinical Trial, Phase III, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural)

Chemical References

• Zinc Sulfate

Topics

• Administration, Oral
• Adult
• Aged
• Aged, 80 and over
• Double-Blind Method
• Drug Administration Schedule
• Female
• Head and Neck Neoplasms (radiotherapy)
• Humans
• Male
• Middle Aged
• Taste Disorders (prevention & control)
• Treatment Outcome
• Zinc Sulfate (administration & dosage)