Frontiers in nutrition
Selenium supplementation for preventing cancer therapy-related toxicities: a systematic review and meta-analysis of clinical trials
By Chang C, Wei J, Li M and 3 others.
Abstract
Background
Trials of selenium for cancer supportive care vary in treatment context, formulation, dose, toxicity domain, and outcome definition. We evaluated the efficacy and safety of selenium supplementation for preventing or reducing cancer therapy-related toxicities.
Methods
PubMed, Web of Science Core Collection, and the Cochrane Library were searched through June 30, 2026. Comparative clinical trials conducted during cancer therapy compared selenium with placebo, no selenium, observation, or selenium-free standard care. Two reviewers independently completed study selection, data extraction, outcome evaluation, and risk-of-bias assessment, with third-reviewer adjudication when required. Severe oral mucositis during head-and-neck radiotherapy or chemoradiotherapy was the primary outcome; broader pools were exploratory. Fixed- or random-effects analyses were supplemented by restricted maximum-likelihood models with Hartung-Knapp confidence intervals. Conference-abstract and derived-odds-ratio analyses were restricted to supplementary sensitivity analyses. Certainty was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD420261448497).