Non-Cochrane · intervention · PM42909097
Selenium supplementation for preventing cancer therapy-related toxicities: a systematic review and meta-analysis of clinical trials.
Chang Chuyue, Wei Juncheng, Li Mengfei, et al. · Frontiers in nutrition · 2026 · PubMed · doi:10.3389/fnut.2026.1940806
Findings
58 findings
| Population | ||||
|---|---|---|---|---|
| Head and neck cancer receiving radiotherapy or chemoradiotherapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Primary: severe oral mucositis, head-and-neck RT/CRT REML heterogeneity estimator with Hartung-Knapp | RR 0.88 [0.35, 2.23] GRADE not reported 4 studies |
| Head and neck cancer receiving radiotherapy or chemoradiotherapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | oral mucositis onset in days | MD 0.98 [-0.44, 2.39] Very low Downgraded: imprecision 2 studies · 131 participants |
| Head and neck cancer receiving radiotherapy or chemoradiotherapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Primary: severe oral mucositis, head-and-neck RT/CRT Placebo-controlled studies only | RR 1.10 [0.78, 1.57] GRADE not reported 2 studies |
| Head and neck cancer receiving radiotherapy or chemoradiotherapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Primary: severe oral mucositis, head-and-neck RT/CRT High-risk studies excluded | RR 0.73 [0.34, 1.56] GRADE not reported 3 studies |
| Head and neck cancer receiving radiotherapy or chemoradiotherapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: oral mucositis onset in days REML heterogeneity estimator with Hartung-Knapp | MD 0.84 [-10.70, 12.38] GRADE not reported 2 studies |
| Head and neck cancer receiving radiotherapy or chemoradiotherapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | severe oral mucositis, head-and-neck RT/CRT | RR 0.89 [0.50, 1.56] -49 [-218, +248] per 1000 Very low Downgraded: risk of bias, imprecision, inconsistency 4 studies · 188 participants |
| Cancer patients receiving radiotherapy, chemoradiotherapy or transplantation | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: severe oral mucositis, expanded contexts REML heterogeneity estimator with Hartung-Knapp | RR 0.71 [0.30, 1.67] GRADE not reported 5 studies |
| Cancer patients receiving radiotherapy, chemoradiotherapy or transplantation | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: severe oral mucositis, expanded contexts High-risk studies excluded | RR 0.58 [0.27, 1.25] GRADE not reported 4 studies |
| Cancer patients receiving radiotherapy, chemoradiotherapy or transplantation | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: severe oral mucositis, expanded contexts Placebo-controlled studies only | RR 0.64 [0.25, 1.64] GRADE not reported 3 studies |
| Cancer patients receiving radiotherapy, chemoradiotherapy or transplantation | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Severe oral mucositis with conference-abstract augmentation Adds Orvain 2025 conference-abstract arm-level data | RR 0.80 [0.44, 1.48] GRADE not reported 6 studies |
| Cancer patients receiving radiotherapy, chemoradiotherapy or transplantation | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Severe oral mucositis with conference-abstract augmentation Adds Orvain 2025 conference-abstract arm-level data | RR 0.83 [0.56, 1.23] GRADE not reported 6 studies |
| Cancer patients receiving radiotherapy, chemoradiotherapy or transplantation | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | oral mucositis duration in days | MD -1.72 [-2.64, -0.80] Very low Downgraded: imprecision 2 studies · 145 participants |
| Cancer patients receiving radiotherapy, chemoradiotherapy or transplantation | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | any oral mucositis | RR 0.98 [0.91, 1.05] -17 [-78, +49] per 1000 Low Downgraded: risk of bias 2 studies · 145 participants |
| Cancer patients receiving radiotherapy, chemoradiotherapy or transplantation | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: any oral mucositis Placebo-controlled studies only | RR 0.98 [0.91, 1.05] GRADE not reported 2 studies |
| Cancer patients receiving radiotherapy, chemoradiotherapy or transplantation | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: any oral mucositis High-risk studies excluded | RR 0.98 [0.91, 1.05] GRADE not reported 2 studies |
| Cancer patients receiving radiotherapy, chemoradiotherapy or transplantation | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: any oral mucositis REML heterogeneity estimator with Hartung-Knapp | RR 0.98 [0.77, 1.24] GRADE not reported 2 studies |
| Cancer patients receiving radiotherapy, chemoradiotherapy or transplantation | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | severe oral mucositis, expanded contexts | RR 0.71 [0.38, 1.33] -119 [-256, +136] per 1000 Very low Downgraded: imprecision, inconsistency, indirectness 5 studies · 262 participants |
| Cancer patients receiving radiotherapy, chemoradiotherapy or transplantation | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: oral mucositis duration in days REML heterogeneity estimator with Hartung-Knapp | MD -1.72 [-4.06, 0.62] GRADE not reported 2 studies |
| Cancer patients receiving cancer-directed therapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | broad toxicity-prevention pool | RR 0.60 [0.42, 0.83] Very low Downgraded: indirectness 11 studies · 745 participants |
| Cancer patients receiving cancer-directed therapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: broad toxicity-prevention pool REML heterogeneity estimator with Hartung-Knapp | RR 0.60 [0.40, 0.89] GRADE not reported 11 studies |
| Cancer patients receiving cancer-directed therapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: severe broad toxicity REML heterogeneity estimator with Hartung-Knapp | RR 0.70 [0.40, 1.23] GRADE not reported 7 studies |
| Cancer patients receiving cancer-directed therapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: severe broad toxicity High-risk studies excluded | RR 0.64 [0.41, 1.01] GRADE not reported 6 studies |
| Cancer patients receiving cancer-directed therapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | grade 3 hematologic toxicity | RR 0.70 [0.50, 0.97] -173 [-286, -16] per 1000 Low Downgraded: risk of bias, imprecision 2 studies · 138 participants |
| Cancer patients receiving cancer-directed therapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: broad toxicity-prevention pool High-risk studies excluded | RR 0.59 [0.40, 0.88] GRADE not reported 8 studies |
| Cancer patients receiving cancer-directed therapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Broad toxicity-prevention pool with conference-abstract augmentation Adds Orvain 2025 conference-abstract arm-level data | RR 0.65 [0.44, 0.96] GRADE not reported 12 studies |
| Cancer patients receiving cancer-directed therapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: grade 3 hematologic toxicity High-risk studies excluded | RR 0.70 [0.50, 0.97] GRADE not reported 2 studies |
| Cancer patients receiving cancer-directed therapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: expanded hematologic toxicity REML heterogeneity estimator with Hartung-Knapp | RR 0.70 [0.49, 1.00] GRADE not reported 4 studies |
| Cancer patients receiving cancer-directed therapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: expanded hematologic toxicity High-risk studies excluded | RR 0.70 [0.50, 0.96] GRADE not reported 4 studies |
| Cancer patients receiving cancer-directed therapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | severe broad toxicity | RR 0.71 [0.46, 1.09] Very low Downgraded: imprecision, indirectness 7 studies · 452 participants |
| Cancer patients receiving cancer-directed therapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: grade 3 hematologic toxicity Placebo-controlled studies only | RR 0.70 [0.50, 0.97] GRADE not reported 2 studies |
| Cancer patients receiving cancer-directed therapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Broad toxicity-prevention pool with conference-abstract augmentation Adds Orvain 2025 conference-abstract arm-level data | RR 0.66 [0.48, 0.90] GRADE not reported 12 studies |
| Cancer patients receiving cancer-directed therapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: grade 3 hematologic toxicity REML heterogeneity estimator with Hartung-Knapp | RR 0.70 [0.46, 1.06] GRADE not reported 2 studies |
| Cancer patients receiving cancer-directed therapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: severe broad toxicity Placebo-controlled studies only | RR 0.73 [0.45, 1.18] GRADE not reported 4 studies |
| Cancer patients receiving cancer-directed therapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: expanded hematologic toxicity Placebo-controlled studies only | RR 0.71 [0.51, 0.99] GRADE not reported 3 studies |
| Cancer patients receiving cancer-directed therapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: broad toxicity-prevention pool Placebo-controlled studies only | RR 0.58 [0.34, 1.02] GRADE not reported 6 studies |
| Cancer patients receiving cancer-directed therapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | expanded hematologic toxicity | RR 0.70 [0.50, 0.96] -115 [-188, -14] per 1000 Very low Downgraded: indirectness 4 studies · 242 participants |
| Cancer patients receiving radiotherapy or chemotherapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: diarrhea event Placebo-controlled studies only | no estimate extracted GRADE not reported 1 study |
| Cancer patients receiving radiotherapy or chemotherapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: diarrhea event REML heterogeneity estimator with Hartung-Knapp | RR 0.70 [0.002, 204.19] GRADE not reported 2 studies |
| Cancer patients receiving radiotherapy or chemotherapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: gastrointestinal toxicity or diarrhea High-risk studies excluded | RR 0.70 [0.42, 1.16] GRADE not reported 2 studies |
| Cancer patients receiving radiotherapy or chemotherapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | diarrhea event | RR 0.60 [0.37, 0.98] -121 [-191, -7] per 1000 Very low Downgraded: risk of bias, imprecision, inconsistency 2 studies · 185 participants |
| Cancer patients receiving radiotherapy or chemotherapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Diarrhea with conference-abstract augmentation Adds Orvain 2025 conference-abstract arm-level data | RR 0.60 [0.39, 0.94] GRADE not reported 3 studies |
| Cancer patients receiving radiotherapy or chemotherapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: diarrhea event High-risk studies excluded | no estimate extracted GRADE not reported 1 study |
| Cancer patients receiving radiotherapy or chemotherapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Diarrhea with conference-abstract augmentation Adds Orvain 2025 conference-abstract arm-level data | RR 0.60 [0.23, 1.56] GRADE not reported 3 studies |
| Cancer patients receiving radiotherapy or chemotherapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: gastrointestinal toxicity or diarrhea Placebo-controlled studies only | no estimate extracted GRADE not reported 1 study |
| Cancer patients receiving radiotherapy or chemotherapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: gastrointestinal toxicity or diarrhea REML heterogeneity estimator with Hartung-Knapp | RR 0.61 [0.28, 1.33] GRADE not reported 3 studies |
| Cancer patients receiving radiotherapy or chemotherapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | gastrointestinal toxicity or diarrhea | RR 0.61 [0.42, 0.88] -142 [-208, -45] per 1000 Very low Downgraded: imprecision, indirectness 3 studies · 271 participants |
| Cancer patients receiving cisplatin-containing chemotherapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: renal toxicity event High-risk studies excluded | RR 0.31 [0.10, 1.00] GRADE not reported 2 studies |
| Cancer patients receiving cisplatin-containing chemotherapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: renal toxicity event REML heterogeneity estimator with Hartung-Knapp | RR 0.27 [8.59e-06, 8202.54] GRADE not reported 2 studies |
| Cancer patients receiving cisplatin-containing chemotherapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | renal toxicity event | RR 0.31 [0.10, 1.00] -98 [-129, +0] per 1000 Very low Downgraded: risk of bias, imprecision 2 studies · 196 participants |
| Cancer patients receiving cisplatin-containing chemotherapy | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: renal toxicity event Placebo-controlled studies only | RR 0.31 [0.10, 1.00] GRADE not reported 2 studies |
| Cancer patients receiving cancer-directed treatment | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | pain grade >=2 Unresolved: the two extractors disagree on this row. | RR 0.78 [0.64, 0.95] -169 [-279, -35] per 1000 Low 2 studies · 146 participants |
| Cancer patients receiving cancer-directed treatment | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: pain grade >=2 REML heterogeneity estimator with Hartung-Knapp | RR 0.74 [0.09, 5.98] GRADE not reported 2 studies |
| Cancer patients receiving cancer-directed treatment | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Exploratory: pain grade >=2 High-risk studies excluded | RR 0.78 [0.64, 0.95] GRADE not reported 2 studies |
| Patients receiving high-dose therapy and hematopoietic stem-cell transplantation | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Severe oral mucositis in transplant settings Adds Orvain 2025 conference-abstract arm-level data | RR 0.62 [3.88e-04, 977.21] GRADE not reported 2 studies |
| Patients receiving high-dose therapy and hematopoietic stem-cell transplantation | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Severe oral mucositis in transplant settings Adds Orvain 2025 conference-abstract arm-level data | RR 0.90 [0.66, 1.22] GRADE not reported 2 studies |
| Pelvic cancer patients receiving radiotherapy or chemoradiotherapy | No selenium | Selenium supplementation | Pelvic chemoradiotherapy grade 2-3 diarrhea Combines reported Bahador OR with reconstructed Muecke category-contrast OR | OR 3.76 [1.78, 7.94] GRADE not reported 2 studies |
| Pelvic cancer patients receiving radiotherapy or chemoradiotherapy | No selenium | Selenium supplementation | Pelvic chemoradiotherapy grade 2-3 diarrhea Combines reported Bahador OR with reconstructed Muecke category-contrast OR | OR 3.76 [1.51, 9.33] GRADE not reported 2 studies |
| Cancer patients receiving cancer-directed treatment | Selenium supplementation during cancer therapy | Placebo, no selenium, observation or selenium-free standard care | Pain grade >=2 Placebo-controlled studies only | no estimate extracted No studies found 0 studies |
Included primary studies 34
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Wang 2020 matched by author and year (probable) | NR | 5 other reviews | not stated | not extracted yet |
| Song 2018 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Ameri 2016 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Asfour 2006 Effect of high-dose sodium selenite therapy on polymorphonuclear leukocyte apoptosis in non-Hodgkin's lymphoma patients. PMID:16679545 | 2006 | this review only | not stated | not extracted yet |
| Bahador 2022 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Brodin 2015 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Buentzel 2010 Limited effects of selenium substitution in the prevention of radiation-associated toxicities. results of a randomized study in head and… PMID:20592387 | 2010 | this review only | not stated | not extracted yet |
| Chen 2023 The effect of selenium yeast in the prevention of adverse reactions related to platinum-based combination therapy in patients with… PMID:37975373 | 2023 | this review only | not stated | not extracted yet |
| Corcoran 2010 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Evans 2020 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Fakih 2006 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Fakih 2008 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Ghorbani 2013 Protective effect of selenium on cisplatin induced nephrotoxicity: A double-blind controlled randomized clinical trial. PMID:24475439 | 2013 | this review only | not stated | not extracted yet |
| Hu 1997 The protective role of selenium on the toxicity of cisplatin-contained chemotherapy regimen in cancer patients. PMID:9197929 | 1997 | this review only | not stated | not extracted yet |
| Jahangard-Rafsanjani 2013 The efficacy of selenium in prevention of oral mucositis in patients undergoing hematopoietic SCT: a randomized clinical trial. PMID:23292233 | 2013 | this review only | not stated | not extracted yet |
| Knox 2019 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Laali 2020 Effect of Selenium on Incidence and Severity of Mucositis during Radiotherapy in Patients with Head and Neck Cancer. PMID:32895660 | 2020 | this review only | not stated | not extracted yet |
| Micke 2003 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Mix 2015 Randomized phase II trial of selenomethionine as a modulator of efficacy and toxicity of chemoradiation in squamous cell carcinoma of the… PMID:26468453 | 2015 | this review only | not stated | not extracted yet |
| Mix/Rajan 2015 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Muecke 2010 Multicenter, phase 3 trial comparing selenium supplementation with observation in gynecologic radiation oncology. PMID:20133068 | 2010 | this review only | not stated | not extracted yet |
| Orvain 2025 Intravenous selenium to prevent oral mucositis in patients with lymphoma or myeloma undergoing high-dose therapy followed by autologous… DOI:10.1200/jco.2025.43.16_suppl.12091 | 2025 | this review only | not stated | not extracted yet |
| Orvain 2025 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Pavlidis 2026 A Comparative Study on the Efficacy of Zinc and Selenium Supplementation for the Prevention of Oral Mucositis in Head and Neck Cancer… DOI:10.1007/s12070-026-06424-9 | 2026 | this review only | not stated | not extracted yet |
| Pavlidis 2026 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Rajan 2013 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Sieja 2004 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Son 2017 Effect of selenium supplementation for protection of salivary glands from iodine-131 radiation damage in patients with differentiated… PMID:28315910 | 2017 | this review only | not stated | not extracted yet |
| Vieira 2015 Supplementation with selenium can influence nausea, fatigue, physical, renal, and liver function of children and adolescents with cancer. PMID:25379637 | 2015 | this review only | not stated | not extracted yet |
| Wang 2020 DOI:10.13267/j.cnki.syzlzz.2020.06.014 | NR | this review only | not stated | not extracted yet |
| Yang 2023 Effects of selenium supplementation on concurrent chemoradiotherapy in patients with cervical cancer: A randomized, double-blind,… PMID:36819673 | 2023 | this review only | not stated | not extracted yet |
| Yim 2026 Efficacy and safety of intravenous administration of high-dose selenium for preventing chemotherapy-induced peripheral neuropathy in… PMID:41630017 | 2026 | this review only | not stated | not extracted yet |
| Zakharia 2025 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Zimmermann 2005 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients with cancer receiving cancer-directed treatment (chemotherapy, radiotherapy, concurrent chemoradiotherapy, high-dose chemotherapy with HSCT, radioiodine therapy) | Patients with head-and-neck, cervical, gynecologic, pelvic, ovarian, hematologic and other cancers receiving RT, CRT, chemotherapy, HSCT or radioiodine (n=17 main-analysis studies; 1,063 participants) |
| Intervention | Selenium supplementation with selenium-specific attribution | Intravenous sodium selenite pentahydrate, oral sodium selenite, selenium yeast, L-selenomethionine, selenium-glycine, seleno-kappa-carrageenan and other oral selenium (n=17) |
| Comparison | Placebo, no selenium, observation, or standard care without selenium | Placebo, no selenium/observation, or standard care without selenium (n=17) |
| Outcomes | Primary: severe (grade 3 or higher) oral mucositis during head-and-neck RT/CRT. Other efficacy: treatment-related toxicities, severity or duration, validated toxicity scores (expanded and any oral mucositis, mucositis duration and onset, hematologic toxicity, diarrhea, gastrointestinal toxicity, renal toxicity, pain, severe broad toxicity, broad toxicity pool). Safety: selenium-attributed adverse events, serious adverse events, dose-limiting toxicity, treatment interruption or completion. Contextual: quality of life, nutrition, performance, selenium status, tumor response, survival | Severe oral mucositis head-and-neck RT/CRT (n=4); expanded severe oral mucositis (n=5); any oral mucositis (n=2); mucositis duration (n=2); onset (n=2); grade 3 hematologic toxicity (n=2); expanded hematologic toxicity (n=4); diarrhea (n=2); gastrointestinal toxicity or diarrhea (n=3); renal toxicity (n=2); pain grade 2 or higher (n=2); severe broad toxicity (n=7); broad toxicity pool (n=11); CIPN, salivary gland injury and taste single-study only |
| Study designs | Comparative clinical trials (randomized and older comparative clinical studies); phase I, single-arm, conference reports mapped as supplementary evidence | Randomized trials (double-blind placebo-controlled, open-label, crossover, phase II/pilot) (n=17 main); 13 supplementary study groups |
| Timing | During cancer therapy | During cancer therapy |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Yes | Partial Yes | no |
| 3Choice of study designs explained | Yes | Yes | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Yes | Yes | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | Yes | Yes | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | Yes | Yes | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | High | High | yes |