Example Queries - Selenium

What are the indications for taking selenium?

	Outcome name	Results during intervention	Overall RoB judgment
Asfour et al. (2006): Effect of high-dose sodium selenite therapy on polymorphonuclear leukocyte apoptosis in non-Hodgkin's lymphoma patients	Ejection fraction	After chemotherapy (8 days): significantly better cardiac ejection fraction in sodium selenite arm (mean(SD)= 63(6%)) vs. control arm (69(6%)); p <0.05	high risk
Jahangard-Rafsanjani et al. (2013): The efficacy of selenium in prevention of oral mucositis in patients undergoing hematopoietic SCT: a randomized clinical trial	Haematological indices	No difference between arms (p=0.32, p=0.87)	some concerns
Jahangard-Rafsanjani et al. (2013): The efficacy of selenium in prevention of oral mucositis in patients undergoing hematopoietic SCT: a randomized clinical trial	Fever	Fever above 38.3°C in 72 patients (97.3%) during neutropenia; duration of fever comparable in both selenium and placebo arm ; p=0.98	some concerns
Karp et al. (2012): Randomized, double-blind, placebo-controlled, phase III chemoprevention trial of selenium supplementation in patients with resected stage I non-small-cell lung cancer: ECOG 5597	DFS (Disease-Free Survival)	During study: n=44 non-melanoma skin cancers, (n=14 vs. n=13 basal cell carcinoma; n=11 vs. n=6 squamous cell carcinoma in intervention vs. placebo arm), no significance values given	low risk
Mix et al. (2015): Randomized phase II trial of selenomethionine as a modulator of efficacy and toxicity of chemoradiation in squamous cell carcinoma of the head and neck	Quality of life	No significant difference for the 7 weeks of intervention	some concerns
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What effects of selenium have been investigated?

	Outcome name	Outcome specification
Asfour et al. (2006): Effect of high-dose sodium selenite therapy on polymorphonuclear leukocyte apoptosis in non-Hodgkin's lymphoma patients	Toxicity Ejection fraction	Infectionrate after chemotherapy Cardiac ejection fraction
Büntzel et al. (2010): Limited effects of selenium in the prevention of radiation-associated toxicities - results of a randomized study in head neck cancer patients	Toxicity	Grade of radiotherapy-associated side effects: Xerostomia, stomatitis, ageusia, and dysphagia
Büntzel et al. (2010): Selenium Substitution During Radiotherapy of Solid Tumours - Laboratory Data from Two Observation Studies in Gynaecological and Head and Neck Cancer Patients	Selenium level	Serum concentration and whole blood concentration
Goossens et al. (2016): Phase III randomised chemoprevention study with selenium on the recurrence of non-invasive urothelial carcinoma. The SELEnium and BLAdder cancer Trial	RFS (Recurrence-Free Survival) PFS (Progression-Free Survival) Selenium level	NA NA Measured at baseline and after 3 years
Jahangard-Rafsanjani et al. (2013): The efficacy of selenium in prevention of oral mucositis in patients undergoing hematopoietic SCT: a randomized clinical trial	Haematological indices Length of hospital stay Incidence of acute GVHD (Graft-Versus-Host Disease) Mortality rate Non-haematological indices Selenium level Mucositis Fever	Neutrophil and platelet engraftment time (the time point after transplantation at which a patient can maintain a sustained ANC of 4500 cells/mm3 and a sustained platelet count of at least 20 000/mm3 lasting 3 consecutive days without transfusions during hospital stay) NA Graft-versus-host disease is a condition where the donated stem cells (graft) attack the recipient's body (host) At 3 months Serum creatinine level and blood urea nitrogen test for renal function assessment and aspartate aminotransferase and alanine transaminase for liver function assessment, recorded daily NA Oral Mucositis Duration of fever
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Does selenium help with mucositis?

	Outcome specification	Results during intervention	Results after intervention	Overall RoB judgment
Jahangard-Rafsanjani et al. (2013): The efficacy of selenium in prevention of oral mucositis in patients undergoing hematopoietic SCT: a randomized clinical trial	Oral Mucositis	Onset of mucositis after transplantation comparable in both selenium and placebo arm; p=0.81	Overall: Cumulative incidence (grade 1-4) comparable in both selenium arm (83.8%) and placebo arm (81.1%); p=0.76; grade 3-4 mucositis significantly lower in selenium arm (10.8%) compared to placebo arm (35.1%); p=0.013 (grade 4: 2x in placebo arm, 0x in selenium arm) Mean duration comparable (p=0.048), only duration of objective mucositis from grade 2 to 4 and back was significantly shorter in the selenium arm (3.6±1.84 days) than in the placebo arm (5.3±2.2 days); p=0.014	high risk
Laali et al. (2020): Effect of Selenium on Incidence and Severity of Mucositis during Radiotherapy in Patients with Head and Neck Cancer	Inflammation of the oral mucosa (mucositis) due to radiotherapy	Significant difference for incidence of severe mucositis at week 3: selenium arm 9.8% vs. placebo arm 42.0% (p=0.017)	After 7 weeks no significant differences between the selenium arm and the placebo arm for: mean duration of oral mucositis (grade 1–4) (p=0.27) onset of oral mucosits (p =0.31) recovery (day after radiation completion (p=0.80) cumulative incidence of oral mucusitis (grade 1–4) (p=0.79) Severe oral mucositis (grade 3 or 4) was seen in 25 patients in the selenium arm and in 20 patients in the placebo arm. Addition: Development of oral mucositis in patients with selenium levels >65 mcg/l significantly delayed from baseline (p=0.04, no further explanation given)	high risk
Mix et al. (2015): Randomized phase II trial of selenomethionine as a modulator of efficacy and toxicity of chemoradiation in squamous cell carcinoma of the head and neck	Grade 3 or 4	NA	Overall: No significant differences between arms (grade 3 intervention arm 2x, placebo arm 3x, no grade 4)	some concerns

What helps against mucositis in cancer?

	Outcome topic	Results during intervention	Results after intervention	Overall RoB judgment
Jahangard-Rafsanjani et al. (2013): The efficacy of selenium in prevention of oral mucositis in patients undergoing hematopoietic SCT: a randomized clinical trial	Selenium	Onset of mucositis after transplantation comparable in both selenium and placebo arm; p=0.81	Overall: Cumulative incidence (grade 1-4) comparable in both selenium arm (83.8%) and placebo arm (81.1%); p=0.76; grade 3-4 mucositis significantly lower in selenium arm (10.8%) compared to placebo arm (35.1%); p=0.013 (grade 4: 2x in placebo arm, 0x in selenium arm) Mean duration comparable (p=0.048), only duration of objective mucositis from grade 2 to 4 and back was significantly shorter in the selenium arm (3.6±1.84 days) than in the placebo arm (5.3±2.2 days); p=0.014	high risk
Laali et al. (2020): Effect of Selenium on Incidence and Severity of Mucositis during Radiotherapy in Patients with Head and Neck Cancer	Selenium	Significant difference for incidence of severe mucositis at week 3: selenium arm 9.8% vs. placebo arm 42.0% (p=0.017)	After 7 weeks no significant differences between the selenium arm and the placebo arm for: mean duration of oral mucositis (grade 1–4) (p=0.27) onset of oral mucosits (p =0.31) recovery (day after radiation completion (p=0.80) cumulative incidence of oral mucusitis (grade 1–4) (p=0.79) Severe oral mucositis (grade 3 or 4) was seen in 25 patients in the selenium arm and in 20 patients in the placebo arm. Addition: Development of oral mucositis in patients with selenium levels >65 mcg/l significantly delayed from baseline (p=0.04, no further explanation given)	high risk
Mansourian et al. (2015): The effect of "curcuma Longa" topical gel on radiation -induced oral mucositis in patients with head and neck cancer	Curcumin	Significant difference between intervention vs. placebo arm in mean (SD): intervention 3.7 (2.1) vs. placebo 7.9 (2.0); p < 0.001	NA	some concerns
Mansourian et al. (2015): The effect of "curcuma Longa" topical gel on radiation -induced oral mucositis in patients with head and neck cancer	Curcumin	Max. degree of mucositis (number (%) of patients): Grade 1: Intervention arm: 15 (78.9%), Placebo arm: 3 (16.7%) Grade 2: Intervention arm: 4 (21.1%), Placebo arm: 8 (44.4%) Grade 3: Intervention arm: 0 (0%), Placebo arm: 7 (38.9%) Grade 4: Intervention arm and Placebo arm: 0 Difference between arms in distribution of grades: p < 0.001 Time between T0 and onset of max. mucositis: no numbers given; p = 0.315 Incidence of max. mucositis (number (%)): 7 days: Intervention arm: 4 (21.1%), Placebo arm: 8 (44.4%) 14 days: Intervention arm: 6 (31.6%), Placebo arm: 4 (22.2%) 21 days: Intervention arm: 9 (47.4%), Placebo arm: 6 (33.3%)	NA	some concerns
Mix et al. (2015): Randomized phase II trial of selenomethionine as a modulator of efficacy and toxicity of chemoradiation in squamous cell carcinoma of the head and neck	Selenium	NA	Overall: No significant differences between arms (grade 3 intervention arm 2x, placebo arm 3x, no grade 4)	some concerns
... further results