Antioxidant may have adverse effects in head and neck cancer patients

Alpha-tocopherol supplementation may have unexpected adverse effects on the occurrence of second primary cancers and on cancer-free survival in patients with head and neck cancer, according to a new study in the April 6 issue of the Journal of the National Cancer Institute.

Studies have found an association between low dietary intake of antioxidants and an increased risk of cancer, but trials that have tested the cancer-preventive effects of antioxidant supplementation have had mixed results. Two of the most studied vitamins have been alpha-tocopherol (vitamin E) and beta-carotene, a precursor of vitamin A.

To determine whether antioxidant supplementation could reduce the risk of second primary cancers in head and neck cancer patients, Isabelle Bairati, M.D., Ph.D., of the Universit Laval in Qubec City, Qubec, and colleagues conducted a multicenter, double-blind, placebo-controlled, randomized trial among 540 patients with stage I or II head and neck cancer who had been treated with radiation therapy between 1994 and 2000. Participants received supplementation with alpha-tocopherol and beta-carotene or a placebo during radiation therapy and for the next 3 years. (Beta-carotene supplementation was discontinued about 1 year into the trial because results from a different large trial found an increased incidence of lung cancer among smokers receiving beta-carotene.) Participants were followed for a median of 52 months.

Compared with patients given a placebo, patients who received alpha-tocopherol supplements had a higher rate of developing a second primary cancer during the period of supplementation but a lower risk of a second primary cancer after supplementation ended. Overall, the proportion of participants free of a second primary cancer after 8 years of follow-up was similar in both groups of patients. The rate of having a recurrence of the head and neck cancer or a second primary cancer was also higher during supplementation among p

Contact: Sarah L. Zielinski
Journal of the National Cancer Institute

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