Efficacy of Topical and Systemic Vitamin E in Preventing Chemotherapy-Induced Oral Mucositis

Abstract

Background: There is still no consensus regarding the optimum treatment of chemotherapy-induced oral mucositis and its management is still mainly supportive. Vitamin E has been shown to be effective in reducing the symptoms of oral mucositis.

Objectives: Aim of this study was to assess the efficacy of prophylactic systemic and topical vitamin E in reducing the signs and symptoms of oral mucositis in patients receiving chemotherapy.

Patients and Methods: We conducted a placebo-controlled randomized clinical trial among 76 patients with a hematologic malignancy treated with chemotherapy. Patients were randomly assigned into three groups: supplementation with vitamin E paste (group 1) and 200 mg/d vitamin E pills (group 2). Group 3 received placebo paste, identical in appearance and taste to the vit E paste, but consisting of the vehicle only. Patients were advised to use the administered medication from two days before each cycle of chemotherapy till at least 20 days after completion of each cycle. Oral exam was performed 10-14 days after each cycle of chemotherapy.

Results: Patients in group 2 and 3 did not show any difference in degree of mucositis or severity of pain. However, after the second cycle, patients who were treated with topical vitamin E showed significantly less oral pain, and had fewer cases of severe mucositis compared to groups 2 and 3.

Conclusions: Topical vitamin E could be beneficial in reducing the severity of oral mucositis, but no therapeutic gain would be achieved by using systemic vitamin E in this regard.

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See also:

- Official Web Site: The Di Bella Method;

- The Di Bella Method (A Fixed Part - Alpha tocopheryl acetate/Vitamin E, approximately 20 grams per day orally);

- Cancer and Vitamin E (analogues and/or derivatives) and cancer - In vitro, review and in vivo publications;

- Solution of retinoids in vitamin E in the Di Bella Method biological multitherapy;

- The Di Bella Method (A Fixed Part - All-Trans Retinoic Acid, Analogues and/or Derivatives - Approximately 60mg per day orally: 40mg per day Beta-Carotene/β-Carotene, 10mg per day ATRA and 10mg per day Axerophthol palmitate);

- All-Trans-Retinoic Acid (ATRA - analogues and/or derivatives) - In vitro, review and in vivo publications;

- Beta-Carotene or β-carotene in Solution of retinoids in vitamin E in the Di Bella Method biological multitherapy;

- The Di Bella Method (A Fixed Part - Cyclophosphamide 50mg tablets and/or Hydroxyurea 500mg tablets, one or two per day);

- The Di Bella Method (A Variable Part - Selenium methonine, 40 μg capsules, twice a day);

- The Di Bella Method (A Fixed Part - Vitamin C/Ascorbic Acid, 2–4 grams, twice a day orally);

- Chronic Lymphocytic Leukemia: Long-Lasting Remission with Combination of Cyclophosphamide, Somatostatin, Bromocriptine, Retinoids, Melatonin, and ACTH;

- A case of advanced Multiple Myeloma treated with Di Bella Method (DBM) into total remission for 13 years;

- Cyclophosphamide plus Somatostatin, Bromocriptin, Retinoids, Melatonin and ACTH in the Treatment of Low-grade Non-Hodgkin’s Lymphomas at Advanced Stage: Results of a Phase II Trial;

- Relapse of High-Grade Non-Hodgkin’s Lymphoma After Autologous Stem Cell Transplantation: A Case Successfully Treated With Cyclophosphamide Plus Somatostatin, Bromocriptine, Melatonin, Retinoids, and ACTH;

- Low-grade Non-Hodgkin Lymphoma at Advanced Stage: A Case Successfully Treated With Cyclophosphamide Plus Somatostatin, Bromocriptine, Retinoids, and Melatonin;

- The Di Bella Method (DBM) improved survival, objective response and performance status in a retrospective observational clinical study on 55 cases of Lymphomas;

- Large B-cells Non-Hodgkin's Lymphoma, Stage IV-AE: a Case Report;

- Non-Hodgkin's Lymphoma, Stage III-B-E: a Case Report;

- The Di Bella Method DBM improved survival objective response and performance status in a retrospective observational clinical study on 23 tumours of the head and neck;

- Neuroblastoma: Complete objective response to biological treatment;

- Oesophageal squamocellular carcinoma: a complete and objective response;

- A retrospective observational study on cases of anaplastic brain tumors treated with the Di Bella Method: A rationale and effectiveness;

- Recurrent Glioblastoma Multiforme (grade IV – WHO 2007): a case of complete objective response achieved by means of the concomitant administration of Somatostatin and Octreotide – Retinoids – Vitamin E – Vitamin D3 – Vitamin C – Melatonin – D2 R agonists (Di Bella Method – DBM) associated with Temozolomide.