Neuroprotective effect of vitamin E supplementation in patients treated with cisplatin chemotherapy.
OBJECTIVE
The aim of this study is to evaluate the neuroprotective effect of antioxidant supplementation with vitamin E in patients treated with cisplatin chemotherapy.


METHODS
Between April 1999 and October 2000, forty-seven patients were randomly assigned to either group one, which received vitamin E supplementation during cisplatin chemotherapy, or to group two, which received cisplatin chemotherapy alone. Alpha-tocopherol (vitamin E; 300 mg/d) was administered orally before cisplatin chemotherapy and continued for 3 months after the suspension of treatment. For preclinical studies, nude mice carrying the human melanoma tumor were treated with cisplatin alone or in combination with vitamin E.


RESULTS
Twenty-seven patients completed six cycles of cisplatin chemotherapy: 13 patients in group one and 14 patients in group two. The incidence of neurotoxicity was significantly lower in group one (30.7%) than it was in group two (85.7%; P <.01). The severity of neurotoxicity, measured with a comprehensive neurotoxicity score based on clinical and neurophysiological parameters, was significantly lower in patients who were supplemented with vitamin E than in patients who were not supplemented with vitamin E (2 v 4.7, P <.01). The results of the preclinical studies showed that when cisplatin was combined with vitamin E, no differences were observed in tumor weight inhibition, tumor growth delay, or life span as compared with treatment with cisplatin alone.


CONCLUSIONS
Supplementation of patients receiving cisplatin chemotherapy with vitamin E decreases the incidence and severity of peripheral neurotoxicity.
Pace
Andrea
A
Neuroscience Department, Experimental Chemotherapy Laboratory, Regina Elena National Cancer Institute, Rome, Italy. pace@ifo.it
Savarese
Antonella
A
Picardo
Mauro
M
Maresca
Vittoria
V
Pacetti
Umberto
U
Del Monte
Girolamo
G
Biroccio
Annamaria
A
Leonetti
Carlo
C
Jandolo
Bruno
B
Cognetti
Francesco
F
Bove
Loredana
L
D000328:Adult; D000368:Aged; D000818:Animals; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000975:Antioxidants / Q000627:therapeutic use*; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use*; D019610:Cytoprotection; D019587:Dietary Supplements; D004353:Drug Evaluation, Preclinical; D004359:Drug Therapy, Combination; D004594:Electrophysiology; D005260:Female; D006801:Humans; D008297:Male; D008546:Melanoma, Experimental / Q000517:prevention & control; D051379:Mice; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000503:physiopathology / Q000517:prevention & control*; D014810:Vitamin E / Q000627:therapeutic use*
D000970:Antineoplastic Agents; D000975:Antioxidants; D018696:Neuroprotective Agents; D014810:Vitamin E; D002945:Cisplatin