Antioxidant supplementation during RT

[Palex80]

---

Members do not see this ad.

I just got an email from the German Radiation Oncology Society pointing out at this interesting trial.

Antioxidant supplementation and breast cancer prognosis in postmenopausal women undergoing chemotherapy and radiation therapy. - PubMed - NCBI

I was wondering, what your feelings are on this issue? I think, I'll have to be a more strict with my patients and start asking more questions...

 

[medgator]

I just got an email from the German Radiation Oncology Society pointing out at this interesting trial.

Antioxidant supplementation and breast cancer prognosis in postmenopausal women undergoing chemotherapy and radiation therapy. - PubMed - NCBI

I was wondering, what your feelings are on this issue? I think, I'll have to be a more strict with my patients and start asking more questions...

I always tell my patients to avoid high dose antioxidant supplements during xrt and to discuss with med onc regarding chemo.

The xrt concern is theoretical, as the antioxidants might protect the cancer being treated from the free radicals being generated by xrt, I guess there may be more than theory behind it.

 

[Sheldor]

Oh dang. Look at those hazard ratios! Thanks for sharing this. This comes up a lot in my clinic, and so it will be nice to have some data to point to. I think that anecdotally breast cancer patients tend to be the most prone to taking these things, so this will be very relevant.

 

[scarbrtj]

I just got an email from the German Radiation Oncology Society pointing out at this interesting trial.

Antioxidant supplementation and breast cancer prognosis in postmenopausal women undergoing chemotherapy and radiation therapy. - PubMed - NCBI

I was wondering, what your feelings are on this issue? I think, I'll have to be a more strict with my patients and start asking more questions...

(Not really a trial.) I don't know what to make of it all; I have struggled for years. If a patient loves Kakadu plums and is getting radiation, should MDs recommend the patient forgo certain foods in her diet very high in anti-oxidants? Why would a daily oral tablet of Vitamin C protect the tumor when amifostine, a very potent free radical scavenger, never, ever did in any actual trial? Why don't we ever see markedly lower XRT side effects in any of the oral-OTC-anti-oxidants-can-defeat-XRT lookbacks? There's conflicting data. Maybe anti-oxidants increase survival. I'm skeptical. But who knows.

 

[Phantom1]

There is rationale why anti-oxidants could decrease the activity of radiation therapy. Data such as this analysis support the recommendation to avoid anti-oxidants during radiation therapy. Is this a Phase 3 randomized double blind placebo controlled clinical trial? No. But how hard is it to just tell a patient to avoid high dose anti-oxidants for 6 weeks? Not hard at all, so thats what I do.

 

[evilbooyaa]

Keep it simple, stupid (KISS), is my general motto for this. I make the recommendation to avoid supplemental doses of anti-oxidants. An orange a day is fine. A box of oranges a day is not. etc. etc.

But yes, it is good to have actual data to support this rather than just radiobiological dogma and voodoo.

*EDIT* - Looked through the actual paper. Less than ideal methodology to reach the conclusion. On univariate analysis there was no difference between antioxidant use and mortality. Only when controlling for covariates, because the antioxidant group was slightly more favorable (more screening detected cancers), they note that antioxidant use has slightly worse results.

Won't change my current practice as I said previously, but not a huge issue within Rad Onc.