ROLE OF VITAMIN E IN PREVENTION OF CHEMOTHERAPY INDUCED PERIPHERAL NEUROPATHY

Background: Chemotherapy induced peripheral neuropathy (CIPN) is one of the commonest and disabling side effect of chemotherapy drugs like taxanes , platinum compounds, vinca alkaloids, thalidomide and bortezomib.It often leads to dose reduction and discontinuation of treatment. Many agents like Vitamin E, glutathione, glutamate, acetyl L carnityle have been evaluated for their role in prevention of CIPN without any significant success Hence, CIPN is an important area of research due to lack of effective agent to prevent CIPN. Methodology: Un-blind double arm interventional study

Results: Forty patients were distributed in two groups; intervention (vitamin E supplemented n=20) and control (n=20) arms. The TNSn scores were comparable at baseline and immediately after chemotherapy among both groups. However, after 3 months of chemotherapy the mean TNSn was comparatively low in the intervention arm (0.95 versus 1.64) which was not statistically significant. In subset analysis of Paclitaxel-Cisplatin combination chemotherapy subgroup, TNSn scores of two arms immediately post chemotherapy and at 3 months showed maximum difference between the arms (p-value, <0.001). In subset of Paclitaxel group, TNSn score at baseline and after chemotherapy were comparable. However, TNSn score measured after 3 months of chemotherapy in Intervention arm normalized, in contrast to non-intervention arm which still had a mean TNS of 1 with a p-value of 0.001

Conclusions: Our study showed a protective role of vitamin E profoundly in patients receiving single agent paclitaxel followed by paclitaxel and cisplatin regimen where the recovery from CIPN was much better as compared to control arm.