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Antioxidants and Cancer Therapy: A Systematic Review

From the Division of Pediatric Oncology, Children’s Hospital of New York; Division of Epidemiology, Joseph L. Mailman School of Public Health; Department of Pediatrics, College of Physicians and Surgeons of Columbia University, Columbia University, New York, NY.

Address reprint requests to Kara M. Kelly, MD, Columbia University, Pediatric Oncology, 161 Ft Washington, 7th floor, New York, NY 10032; e-mail: kk291{at}columbia.edu

PURPOSE: Many patients with cancer take antioxidant nutritional supplements during cancer treatment to alleviate treatment toxicities and to improve long-term outcomes, but little is known about the efficacy and safety of antioxidant use during cancer treatment. We reviewed English-language manuscripts published in the biomedical literature, reporting the results of observational studies of antioxidant status and cancer outcomes and of intervention trials of antioxidants among patients receiving chemotherapy with or without radiation for various malignancies.

METHODS: We searched the Medline database and the bibliographies of the retrieved manuscripts, reviews, and books on antioxidants and cancer. The retrieved studies are grouped by study design, malignancy, and end points.

RESULTS: More than 100 citations were retrieved; 52 met our criteria, 31 were observational studies, and 21 were intervention trials. The studies varied in study design, timing of observation/intervention, intervention protocol, malignancy, and anticancer regimen.

CONCLUSION: These inconsistencies preclude a definitive conclusion as to the effect of chemotherapy on antioxidant status in patients undergoing anticancer therapy. However, our review suggests that total antioxidant status (measured by total radical antioxidant parameter) declines during cancer treatment. Adequately powered trials or observational studies among patients with a specific cancer diagnosis receiving a specific treatment regimen are needed to address patients' and physicians' concerns regarding these associations.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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