Lawenda BD, Kelly KM, Ladas EJ, et al. Should Supplemental Antioxidant Administration Be Avoided During Chemotherapy and Radiation Therapy? J Natl Cancer Inst 2008 May 27;1481-783. [Epub ahead of print] (Review)
PMID: 18505970
http://jnci.oxfordjournals.org/cgi/content/abstract/djn148
http://jnci.oxfordjournals.org/cgi/content/full/djn148v1
http://jnci.oxfordjournals.org/cgi/reprint/djn148v1
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Journal of the National Cancer Institute Advance Access published online on May 27, 2008
JNCI Journal of the National Cancer Institute, doi:10.1093/jnci/djn148
© The Author 2008. Published by Oxford University Press.
COMMENTARY
Should Supplemental Antioxidant Administration Be Avoided During Chemotherapy and Radiation Therapy?
Brian D. Lawenda, Kara M. Kelly, Elena J. Ladas, Stephen M. Sagar, Andrew Vickers, Jeffrey B. Blumberg
Affiliations of authors: Uniformed Services University of the Health Sciences, Department of Radiology and Radiological Sciences, Bethesda, MD (BDL); Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN (BDL); Radiation Oncology Division, Breast Health Center, Naval Medical Center San Diego, San Diego, CA (BDL); Integrative Therapies Program for Children with Cancer (EJL), Department of Pediatrics, Division of Pediatric Oncology (KMK), Columbia University Medical Center, New York, NY; Oncology and Medicine, McMaster University, Hamilton, ON, Canada (SMS); Departments of Epidemiology and Biostatistics and Urology, Memorial Sloan Kettering Cancer Center, New York, NY (AV); Friedman School of Nutrition Science and Policy, Antioxidants Research Laboratory, Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (JBB)
Correspondence to: Brian D. Lawenda, MD, MC, USN, Radiation Oncology Division, Breast Health Center, Naval Medical Center San Diego, San Diego, CA (e-mail:
).
Despite nearly two decades of research investigating the use of dietary antioxidant supplementation during conventional chemotherapy and radiation therapy, controversy remains about the efficacy and safety of this complementary treatment. Several randomized clinical trials have demonstrated that the concurrent administration of antioxidants with chemotherapy or radiation therapy reduces treatment-related side effects. Some data indicate that antioxidants may protect tumor cells as well as healthy cells from oxidative damage generated by radiation therapy and some chemotherapeutic agents. However, other data suggest that antioxidants can protect normal tissues from chemotherapy- or radiation-induced damage without decreasing tumor control. We review some of the data regarding the putative benefits and potential risks of antioxidant supplementation concurrent with cytotoxic therapy. On the basis of our review of the published randomized clinical trials, we conclude that the use of supplemental antioxidants during chemotherapy and radiation therapy should be discouraged because of the possibility of tumor protection and reduced survival.
Manuscript received September 10, 2007; revised March 25, 2008; accepted April 7, 2008.