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Vitamin E for prophylaxis against chemotherapy-induced neuropathy

A randomized controlled trial

From the Neurology Department (Drs. Argyriou, Chroni, Ellul, Papapetropoulos, and Katsoulas) and the Department of Medicine–Division of Oncology (Drs. Koutras, Iconomou, and Kalofonos), University of Patras, Medical School, Rion, Greece.

Address correspondence and reprint requests to Dr. Andreas A. Argyriou, Neurology Department, University of Patras, Medical School, PO Box 1045, Rion, Patras, Greece; e-mail: andargyriou{at}yahoo.gr

Background: The authors conducted a pilot, randomized, open label with blind assessment, controlled trial to determine whether vitamin E supplementation has a neuroprotective effect in chemotherapy-induced peripheral nerve damage.

Methods: Thirty-one patients with cancer treated with six courses of cumulative cisplatin, paclitaxel, or their combination regimens were randomly assigned in two groups and followed by neurologic examination and electrophysiologic study. Patients assigned in Group I (n = 16) received oral vitamin E at a daily dose of 600 mg/day during chemotherapy and 3 months after its cessation were compared to patients of Group II (n = 15), who received no supplementation and served as controls. The severity of neurotoxicity was summarized by means of a modified peripheral neuropathy score.

Results: The incidence of neurotoxicity differed between the two groups, occurring in 4/16 (25%) patients assigned in the vitamin E supplementation group and in 11/15 (73.3%) patients assigned in the control group (p = 0.019). Mean peripheral neuropathy scores were 3.4 ± 6.3 for patients of Group I and 11.5 ± 10.6 for patients of Group II (p = 0.026). The relative risk (RR) of developing neurotoxicity was significantly higher in case of control patients, RR = 0.34, 95% CI = 0.14 to 0.84.

Conclusion: Vitamin E supplementation in cancer patients may have an important neuroprotective effect.

Received May 5, 2004. Accepted in final form August 20, 2004.

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