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Efficacy of l-carnitine and silymarin administration on the health-related quality of life in 120 patients with cancer undergoing anthracycline-based chemotherapy Zeinab Alkasaby Zalat, Mohamed M. Abdel-Latif , Badriyah S. Alotaibi, Mohamed A. Alm El-Din, Neveen A. Kohaf, and Hosny A. Elewa Department of Clinical Pharmacy, Faculty of Pharmacy (Girla), Al-Azhar University, Cairo, Egypt. (zeinabalkasaby.pharmg@azhar.edu.eg) Department of Clinical Pharmacy, Faculty of Pharmacy, Assuit University, Assuit, Egypt. 3 Department of Pharmaceutical science, Faculty of Pharmacy, Princess of Nourah bint Abdulrahman University, Riyadh, Saudi Arabia 4 Department of Clinical Oncology, Faculty of Medicine, Tanta University, Tanta, Egypt. Master degree in pharmaceutical Sciences, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt. 6 Department of Pharmacy Practice, Faculty of Pharmacy, Horus University, Dominate City, Egypt. * Corresponding author: helewa@horus.edu.eg Received May 19, 2020; Accepted June 18, 2020; Published June 21, 2020 DOI: 10.21608/jmals.2020.111233 Abstract Objectives: To investigate changes after adding L-carnitine and silymarin compared to anthracycline chemotherapy alone on the health-related quality of life (HRQoL) of women with breast cancer receiving anthracycline-based chemotherapy. Methods: A prospective, randomized comparative, study that included 120 women with breast cancer who received anthracycline in their chemotherapeutic regimen. Patients were divided into three groups, anthracycline alone (control group), chemotherapy and l-carnitine (l-carnitine group), and chemotherapy plus silymarin (silymarin group). HRQoL was evaluated using the EORTC QLQ-C30 and EORTC QLQ-BR23 instruments 7 days before chemotherapy and after the third month of chemotherapy. Results: On the application of (EORTC QLQ-C30), there was a significant decrease in global health status/QoL score, functional scale scores from baseline to after three months (P≤0.001) within the control group and a significant increase in symptom scale scores from baseline to after three months. In l-carnitine and silymarin groups, there was a nonsignificant difference in the scale scores. On the application of (EORTC QLQ-BR23), there was a significant decrease in functional scale scores (p≤0.001) within the control group and a significant increase in symptom scale scores (p≥0.05). In the l-carnitine and silymarin groups, there was a non-significant difference in functional scale scores from baseline to after three months (p≥0.05). Conclusions: QOL was negatively affected by chemotherapy. For BC cases, HRQoL becomes typically worse during the third month of chemotherapy compared with the pretreatment duration. The addition of l-carnitine and silymarin to anthracycline-based chemotherapy showed improvement in the health-related quality of life of cancer patients.

journal of medical and life science

Efficacy of l-carnitine and silymarin administration on the health-related quality of life in 120 patients with cancer undergoing anthracycline-based chemotherapy