title: Supplement use during an intergroup clinical trial for breast cancer (S0221).
abstract: The use of supplements during chemotherapy is controversial, partly due to the potential effect of antioxidants on reduced efficacy of chemotherapy-related cytotoxicity. We examined supplement use among breast cancer patients registered to a clinical trial (SWOG 0221) before diagnosis and during treatment. Patients (n = 1,467) completed questionnaires regarding multivitamin and supplement use at trial registration (baseline) to capture use before diagnosis. Of these patients, 1,249 completed a 6-month followup questionnaire to capture use during treatment. We examined the use of vitamins C, D, E, B6, B12, folic acid, and calcium at these timepoints, as well as physician recommendations regarding supplement use. The use of vitamins C, E, folic acid, and calcium decreased during treatment, while the use of vitamin B6 increased. Five hundred seventy four patients (51 %) received no physician recommendations regarding supplement use. Among the remaining 49, 10 % were advised not to take multivitamins and/or supplements, 7 % were advised to use only multivitamins, and 32 % received recommendations to use multivitamins and/or supplements. Among patients who took vitamin C before diagnosis, those who were advised not to take supplements were >5 times more likely not to use of vitamin C during treatment than those not advised to stop use (OR = 5.27, 95 % CI 1.13-24.6). Previous non-users who were advised to take a multivitamin were nearly 5 times more likely to use multivitamins during treatment compared to those who received no recommendation (OR = 4.66, 95 % CI 2.10-10.3). In this clinical trial for high-risk breast cancer, supplement use generally decreased during treatment. Upon followup from the clinical trial, findings regarding supplement use and survival outcomes will better inform physician recommendations for patients on adjuvant chemotherapy.
authors.affiliation: Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY 14263, USA.
authors.forename: Gary R
authors.initials: GR
authors.lastname: Zirpoli
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Brennan
authors.forename: Chi-Chen
authors.initials: CC
authors.lastname: Hong
authors.forename: Susan E
authors.initials: SE
authors.lastname: McCann
authors.forename: Gregory
authors.initials: G
authors.lastname: Ciupak
authors.forename: Warren
authors.initials: W
authors.lastname: Davis
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Unger
authors.forename: G Thomas
authors.initials: GT
authors.lastname: Budd
authors.forename: Dawn L
authors.initials: DL
authors.lastname: Hershman
authors.forename: Halle C F
authors.initials: HC
authors.lastname: Moore
authors.forename: James
authors.initials: J
authors.lastname: Stewart
authors.forename: Claudine
authors.initials: C
authors.lastname: Isaacs
authors.forename: Timothy
authors.initials: T
authors.lastname: Hobday
authors.forename: Muhammad
authors.initials: M
authors.lastname: Salim
authors.forename: Gabriel N
authors.initials: GN
authors.lastname: Hortobagyi
authors.forename: Julie R
authors.initials: JR
authors.lastname: Gralow
authors.forename: Kathy S
authors.initials: KS
authors.lastname: Albain
authors.forename: Christine B
authors.initials: CB
authors.lastname: Ambrosone
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000975:Antioxidants / Q000008:administration & dosage / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D014815:Vitamins / Q000008:administration & dosage / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D000975:Antioxidants; D014815:Vitamins