RT Journal Article
SR Electronic
T1 Vitamin E neuroprotection for cisplatin neuropathy
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 762
OP 766
DO 10.1212/WNL.0b013e3181d5279e
VO 74
IS 9
A1 A. Pace
A1 D. Giannarelli
A1 E. Galiè
A1 A. Savarese
A1 S. Carpano
A1 M. Della Giulia
A1 A. Pozzi
A1 A. Silvani
A1 P. Gaviani
A1 V. Scaioli
A1 B. Jandolo
A1 L. Bove
A1 F. Cognetti
YR 2010
UL http://n.neurology.org/content/74/9/762.abstract
AB Objective: The clinical use of cisplatin chemotherapy is limited by severe peripheral neurotoxicity reported in up to 90% of patients receiving a cumulative dose higher than 300 mg/m2. The present study evaluates the neuroprotective effect of antioxidant supplementation (vitamin E) in patients treated with cisplatin chemotherapy. Methods: A total of 108 patients treated with cisplatin chemotherapy were randomly assigned to receive vitamin E supplementation (α-tocopherol 400 mg/day) or placebo. Treatment was started orally before chemotherapy and continued for 3 months after the suspension of cisplatin. Results: Of 108 randomized patients, 68 received at least one clinical and neurophysiologic examination after cisplatin CT; 41 patients received a cumulative dose of cisplatin higher than 300 mg/m2 and were eligible for statistical analysis: 17 in the vitamin E group (group 1) and 24 in the placebo group (group 2). The incidence of neurotoxicity was significantly lower in group 1 (5.9%) than in group 2 (41.7%) (p < 0.01). The severity of neurotoxicity, measured with a validated neurotoxicity score (Total Neuropathy Score [TNS]), was significantly lower in patients receiving vitamin E than those receiving placebo (mean TNS 1.4 vs 4.1; p < 0.01). Conclusions: This phase III study confirms the neuroprotective role of vitamin E against cisplatin peripheral neurotoxicity. Vitamin E supplementation should be adopted in patients receiving cisplatin-based chemotherapy. Classification of evidence: This study provides Class II evidence that vitamin E supplementation significantly reduces the relative risk of developing signs or symptoms of neurotoxicity (relative risk = 0.14) (95% confidence interval = 0.02–1.00, p < 0.05). TNS=Total Neuropathy Score.