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Publication: Randomized Trial of Antioxidant Vitamins to Prevent Acute Adverse Effects of Radiation Therapy in Head and Neck Cancer Patients

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Reference
Title Randomized Trial of Antioxidant Vitamins to Prevent Acute Adverse Effects of Radiation Therapy in Head and Neck Cancer Patients
Topic Vitamin A (beta-carotene), Vitamin E
Author Bairati, I, Meyer, F, Gélinas, M, Fortin, A, Nabid, A, Brochet, F, Mercier, J, Têtu, B, Harel, F, Abdous, B, Vigneault, É, Vass, S, del Vecchio, P, Roy, J
Year 2005
Journal Journal of clinical oncology
DOI https://doi.org/10.1200/JCO.2005.05.514

Author's Abstract The abstract and the information and conclusions contained therein were written by the authors of the publication.

Purpose

Many cancer patients take antioxidant vitamin supplements with the hope of improving the outcome of conventional therapies and of reducing the adverse effects of these treatments. A randomized trial was conducted to determine whether supplementation with antioxidant vitamins could reduce the occurrence and severity of acute adverse effects of radiation therapy and improve quality of life without compromising treatment efficacy.

Patients and Methods

We conducted a randomized, double-blind, placebo-controlled trial among 540 head and neck cancer patients treated with radiation therapy. Patients were randomly assigned into two arms. The supplementation with α-tocopherol (400 IU/d) and α-carotene (30 mg/d) or placebos was administered during radiation therapy and for 3 years thereafter.During the course of the trial, supplementation with α-carotene was discontinued because of ethical concerns.

Results

Patients randomly assigned in the supplement arm tended to have less severe acute adverse effects during radiation therapy (odds ratio OR, 0.72; 95% CI, 0.52 to 1.02). The reduction was statistically significant when the supplementation combined α-tocopherol and α-carotene for adverse effects to the larynx (OR, 0.38; 95% CI, 0.21 to 0.71) and overall at any site (OR, 0.38; 95% CI, 0.20 to 0.74). Quality of life was not improved by the supplementation. The rate of local recurrence of the head and neck tumor tended to be higher in the supplement arm of the trial (hazard ratio, 1.37; 95% CI, 0.93 to 2.02).

Conclusion

Supplementation with high doses of α-tocopherol and α-carotene during radiation therapy could reduce the severity of treatment adverse effects. However, this trial suggests that use of high doses of antioxidants as adjuvant therapy might compromise radiation treatment efficacy.



This publication is referenced in the following studies:

  1. Bairati et al. (2005): Randomized Trial of Antioxidant Vitamins to Prevent Acute Adverse Effects of Radiation Therapy in Head and Neck Cancer Patients