Open AccessProtective Effects of Vitamin E on Chemotherapy-Induced Peripheral Neuropathy: A Meta-Analysis of Randomized Controlled Trials
Author(s) -
Huikai Miao,
Rongzhen Li,
Dongni Chen,
Jia Hu,
Youfang Chen,
Chunmei Xu,
Zhesheng Wen
Publication year - 2021
Publication title -
annals of nutrition and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.926
H-Index - 81
eISSN - 1421-9697
pISSN - 0250-6807
DOI - 10.1159/000515620
Subject(s) - medicine , placebo , peripheral neuropathy , chemotherapy induced peripheral neuropathy , randomized controlled trial , meta analysis , chemotherapy , vitamin e , gastroenterology , relative risk , vitamin , incidence (geometry) , confidence interval , surgery , endocrinology , diabetes mellitus , pathology , antioxidant , biochemistry , chemistry , alternative medicine , physics , optics
Chemotherapy-induced peripheral neuropathy (CIPN) is a common symptom, but prophylactic measures cannot still be carried out effectively. In addition, the efficacy of vitamin E in preventing peripheral neurotoxicity caused by chemotherapy is inconclusive. Therefore, we collected the relevant randomized controlled trials (RCTs) and performed a meta-analysis to examine whether the vitamin E has a positive effect in CIPN. Methods: We searched PubMed, EMBASE, Cochrane, and other databases in December 2019 for eligible trials. Two reviewers conducted the analysis independently when studies were homogeneous enough. Results: Eight RCTs, involving 488 patients, were identified. Upon pooling these RCTs, patients who received vitamin E supplementation of 600 mg/day had a lower incidence of CIPN (risk ratio [RR] 0.31; 95% confidence interval [CI] 0.14–0.65; p = 0.002) than the placebo group. Vitamin E played a key role in decreasing the incidence of peripheral neuropathy in the cisplatin chemotherapy group (RR 0.28; 95% CI 0.14–0.54; p = 0.0001). Moreover, vitamin E supplementation significantly decreased patients’ sural amplitude after 3 rounds of chemotherapy (RR −2.66; 95% CI −5.09 to −0.24; p = 0.03) in contrast with that of placebo supplementation, while no significant difference was observed when patients were treated with vitamin E after 6 rounds of chemotherapy. In addition, the vitamin E-supplemented group had better improvement in the neurotoxicity score and lower incidence of reflexes and distal paraesthesias than the control group. Conclusion: Available data in this meta-analysis showed that vitamin E supplementation can confer modest improvement in the prevention of CIPN.