Effect of Vitamin E on oxaliplatin-induced peripheral neuropathy prevention: A randomized controlled trial

Abstract

Background:Peripheral neuropathy is one of the most important limitations of oxaliplatin base regimen, which is the standard for the treatment of colorectal cancer. Evidence has shown that Vitamin E may be protective in chemotherapy-induced peripheral neuropathy. The aim of this study is to evaluate the effect of Vitamin E administration on prevention of oxaliplatin-induced peripheral neuropathy in patients with colorectal cancer.Methods:This was a prospective randomized, controlled clinical trial. Patients with colorectal cancer and scheduled to receive oxaliplatin-based regimens were enrolled in this study. Enrolled patients were randomized into two groups. The first group received Vitamin E at a dose of 400 mg daily and the second group observed, until after the sixth course of the oxaliplatin regimen. For oxaliplatin-induced peripheral neuropathy assessment, we used the symptom experience diary questionnaire that completed at baseline and after the sixth course of chemotherapy. Only patients with a score of zero at baseline were eligible for this study.Results:Thirty-two patients were randomized to the Vitamin E group and 33 to the control group. There was no difference in the mean peripheral neuropathy score changes (after − before) between two groups, after sixth course of the oxaliplatin base regimen (mean difference [after − before] of Vitamin E group = 6.37 ± 2.85, control group = 6.57 ± 2.94; P = 0.78). Peripheral neuropathy scores were significantly increased after intervention compared with a base line in each group (P < 0.001).Conclusions:The results from this current trial demonstrate a lack of benefit for Vitamin E in preventing oxaliplatin-induced peripheral neuropathy.

Electroneurography in the evaluation of oxaliplatin-induced neuropathy in colorectal cancer patients

“…Further clinical trials are necessary to evaluate in patients treated with oxaliplatin regiments [55]. On the other hand, there are disappointed results from the current trial where observed a lack of benefit for Vitamin E in prophylaxis oxaliplatininduced peripheral neuropathy [56]. A nonpharmacological therapy cutaneous electrostimulation seems to be potentially effective in the treatment of oxaliplatin-induced neurotoxicity [52].…”

Lifestyle‐Related Factors in the Self‐Management of Chemotherapy‐Induced Peripheral Neuropathy in Colorectal Cancer: A Systematic Review

“…The majority of the articles reviewed reported results of randomized trials ( N = 11) [19–21, 23, 24, 26–28, 31–33]. Other research designs included nonrandomized trials ( N = 5) [22, 34–37], cross-sectional studies ( N = 2) [3, 11], cohort studies ( N = 2) [25, 29], case series ( N = 1) [38], and a crossover trial ( N = 1) [30].…”

“…Other research designs included nonrandomized trials ( N = 5) [22, 34–37], cross-sectional studies ( N = 2) [3, 11], cohort studies ( N = 2) [25, 29], case series ( N = 1) [38], and a crossover trial ( N = 1) [30]. Furthermore, the study populations were comprised of (exclusively) colon cancer or CRC patients ( N = 15) [3, 11, 21, 22, 24–29, 31–34, 38] and mixed cancer patients, including CRC ( N = 7) [19, 20, 23, 30, 35–37]. …”

“…Four studies graded CIPN according to the National Cancer Institute Common Toxicity Criteria (NCI-CTC) [24, 28, 31, 33], two other studies applied the World Health Organization Toxicity Criteria [30, 32], and further three studies implemented the Neurotoxicity Criteria of Debiopharm (DEB-NTC) [25, 27, 28]. One study used a symptom experience diary questionnaire for peripheral neuropathy assessment [21]. Moreover, two studies used the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) questionnaire [23, 36], two other studies used the Chemotherapy-Induced Peripheral Neuropathy Assessment Tool (CIPNAT) [11, 34], and another two studies used the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire, Chemotherapy-Induced Peripheral Neuropathy scale (EORTC QLQ-CIPN20) [3, 35].…”

“…Three studies investigated the effect of vitamin E (400 mg) on CIPN and found no significant differences between oral administration of vitamin E and placebo [19, 20] or an untreated control group [21]. Contradicting results were found in relation to the effects of the antioxidant alpha-lipoid acid (ALA).…”