title: Efficacy of vitamin A in the prevention of loco-regional recurrence and second primaries in head and neck cancer.
abstract: Chemoprevention with retinoids is currently an experimental approach to prevent local relapses and second primaries in treated head and neck cancer patients. We evaluated the effectiveness of vitamin A in preventing the above events in a randomised trial involving 106 head and neck cancer patients who had achieved complete regression of their disease with radiotherapy and/or surgery. They were randomised to receive retinyl palmitate (200,000 IU per week for 1 year) or placebo. 50 subjects on vitamin A and 43 on placebo completed 1 year supplementation; 49 in the former group and 42 in the latter could be evaluated over a 3 year period from the initiation of the study. One fifth (11/56) of patients in the vitamin A group and one tenth (5/50) in the placebo group had loco-regional recurrence. The frequency of recurrences in stage I patients in the vitamin A group was higher compared to the placebo group, although it was not statistically significant. No second primaries were observed in the vitamin A group; 2 patients in the placebo group had second primaries. No clinically obvious side effects were observed with vitamin A. The higher frequency of recurrences in the vitamin A group is of concern although it may be a chance finding given the small size of the trial. The effect on second primaries is consistent with other observations reported in literature.
authors.affiliation: Regional Cancer Centre, Trivandrum, India.
authors.forename: R
authors.initials: R
authors.lastname: Jyothirmayi
authors.forename: K
authors.initials: K
authors.lastname: Ramadas
authors.forename: C
authors.initials: C
authors.lastname: Varghese
authors.forename: R
authors.initials: R
authors.lastname: Jacob
authors.forename: M K
authors.initials: MK
authors.lastname: Nair
authors.forename: R
authors.initials: R
authors.lastname: Sankaranarayanan
mesh_terms: D016588:Anticarcinogenic Agents / Q000627:therapeutic use*; D004224:Diterpenes; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000517:prevention & control*; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000517:prevention & control*; D000084562:Retinyl Esters; D014801:Vitamin A / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D016588:Anticarcinogenic Agents; D004224:Diterpenes; D000084562:Retinyl Esters; D014801:Vitamin A; C014794:retinol palmitate