E Protects Against Neurotoxicity from Chemotherapy Agent Cisplatin
with oral vitamin E during cisplatin chemotherapy significantly reduced
the incidence and severity of neurotoxicity, according to the results
of a randomized trial reported in the March issue of the Journal
of Clinical Oncology.
other chemotherapeutic agents are known to generate oxygen free-radicals
that induce membrane lipid peroxidation with
subsequent extensive tissue damage," write Andrea Pace and
colleagues from the Regina Elena National Cancer Institute and
the S. Gallicano Institute in Rome, Italy. "Recent studies
have demonstrated a reduction in ototoxicity, renal toxicity, and
hematologic toxicity in animals treated with cisplatin plus supplementation
with high doses of antioxidants."
In experiments with the M14 human melanoma cell line, adding alpha-tocopherol
to cisplatin did not reduce the efficacy of cisplatin. Conversely,
the addition of alpha-tocopherol increased survival in mice treated
with high-dose cisplatin. Between April 1999 and October 2000,
47 patients were randomized to receive cisplatin chemotherapy alone
or in combination with alpha-tocopherol, 300 mg/day, given orally
before cisplatin chemotherapy and continued for three months after
treatment was completed.
Among 27 patients
who completed six cycles of cisplatin chemotherapy, the incidence
of neurotoxicity was 30.7% in the group receiving
vitamin E compared with 85.7% in the unsupplemented group (P < .01),
and the neurotoxicity that did occur in the supplemented group
was less severe (P < .01).
"The results of our study indicate that vitamin E supplementation
significantly protects against cisplatin-induced peripheral neurotoxicity
and reduces the incidence and intensity of neuropathic signs and
symptoms. Nonetheless, the efficacy of neuroprotection with vitamin
E supplementation has to be assessed in larger studies," the
authors write. "Our in vivo experiment showed that administration
of vitamin E does not impair the therapeutic efficacy of cisplatin."
J Clin Oncol. 2003;21:927-931
Source: American Nutraceutical Association
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