Written by Luc Geeraert and the CAM-Cancer Consortium.
Updated September 30, 2015

Vitamin E during cancer treatment

Does it work?

No clinical trials using vitamin E monotherapy as an anticancer treatment have been published.

The available peer-reviewed literature describes the use of vitamin E as a component of multivitamin regimens or mixtures of micronutrients, in combination with non-cancer drugs, or as an adjunct to conventional chemotherapy or radiation. Only the peer-reviewed literature describing studies measuring the isolated contribution of vitamin E in such combination therapies have been considered. Please see table 1 for a description of studies.

Cancer treatment

In a phase I clinical trial in 12 patients with incurable malignancies, supplementation of chemotherapy (5-fluorouracil + leucovorin) with oral alpha-tocopherol did not increase its anticancer effect when compared with historical data 16. Addition of maximal therapeutic doses of alpha-tocopherol to chemotherapy did not increase the side effects of the chemotherapy itself, again when compared with historical data.

In a non-randomized, double-blind, placebo-controlled pilot clinical trial, in 240 women with early breast cancer, adjuvant palm oil tocotrienol-rich fraction did not decrease breast-cancer-specific mortality or breast cancer recurrence as compared to tamoxifen alone 17. (See also table 1.)

Reduction of adverse effects

A number of studies describe the addition of vitamin E supplements to conventional anticancer therapies in an effort to reduce its adverse effects. The studies are described in table 1.

Oral all-rac-alpha-tocopherol supplementation did not protect against radiation-related adverse events nor did the compound have an effect on quality of life in a randomized, double-blind, placebo-controlled study of 248 head and neck cancer patients treated with radiotherapy 18-20. In a randomized, controlled study of 60 patients with oral cancer it was found that oral alpha-tocopherol may protect cell membranes from radiation damage 21. In 62 endometrial and cervical cancer patients, topical alpha-tocopherol acetate was found to reduce the acute adverse effects of radiotherapy on the vagina 22.

Several studies, including paediatric studies, found indications that topical vitamin E supplementation might prevent oral mucositis induced by chemotherapy or radiotherapy. In a randomized, double-blind, placebo-controlled study in 18 patients treated with chemotherapy for various types of malignancy, topical vitamin E oil was more effective in resolving oral lesions than was placebo 23. In a randomized, placebo-controlled study in 19 acute myeloid leukaemia patients, topical all-rac-alpha-tocopherol, in addition to chemotherapy, prevented mucositis especially during induction therapy 24. A randomized, double-blind, placebo-controlled in 54 head and neck cancer patients treated with radiotherapy, found prevention of oral mucositis by topical all-rac-alpha-tocopherol acetate 25. In children, similar findings were reported. In a randomized study in 80 children treated with chemotherapy, topical vitamin E was found to be an effective treatment of chemotherapy-induced oral mucositis, while oral vitamin E was not effective 26. A randomized, single-blind, placebo-controlled study in 72 chemotherapy-treated children with haematological malignancies found topical tocopherol acetate to be an effective treatment of oral mucositis 27. However, series of N-of-1, double-blind, randomized, placebo-controlled trials in 16 children treated with doxorubicin-containing regimens did not find reduction of chemotherapy-induced oral mucositis by topical all-rac-alpha-tocopherol 28.

Two studies were performed to assess the effect of vitamin E on radiation-induced cutaneous damage: a randomized, double-blind, placebo-controlled study in 24 patients testing oral alpha-tocopherol 29, and a controlled study in 100 breast cancer patients testing topical vitamin E 30. In combination with pentoxifylline, a drug improving blood flow through peripheral blood vessels, oral vitamin E supplementation was found to reduce radiation-induced fibrosis, but vitamin E alone had no effect.

In a randomized, controlled study in 89 oral cavity cancer patients 31, and in a randomized, double-blind, placebo-controlled in 36 patients with thyroid cancer 32, oral alpha-tocopherol and oral vitamin E, respectively, were found to protect salivary glands against radiation-induced dysfunctions.

In four randomized, controlled or placebo-controlled clinical studies including 47, 31, 30, and 32 cancer patients respectively treated with cisplatin and/or paclitaxel, alpha-tocopherol acetate supplementation reduced the incidence and severity of chemotherapy-induced neurotoxicity 33-36. This finding was confirmed in a bigger randomized, double-blind, placebo-controlled study in 108 cancer patients treated with cisplatin 37. However, in a randomized, double-blind, placebo-controlled study in 207 cancer patients treated with taxanes or platinum compounds 38, and in a randomized, double-blind, placebo-controlled study in 34 patients with colorectal and gastric cancer treated with oxaliplatin-based regimens 39, oral all-rac-alpha-tocopherol and oral vitamin E, respectively, were not found to reduce incidence and severity of chemotherapy-induced neurotoxicity.

Supplementation with oral vitamin E or oral alpha-tocopherol, respectively, did not protect against cardiotoxicity caused by doxorubicin in a randomized controlled study in 63 patients with acute myeloid leukaemia 40, and in an uncontrolled trial in 21 patients with metastatic breast cancer 41.

In three uncontrolled trials, in 5 and 32 breast cancer patients, and in 14 patients with hepatocellular carcinoma, respectively, oral vitamin E supplementation was beneficial to the resolution of hand-foot skin syndrome related to sorafenib or capecitabine therapy 42-44. These results are preliminary at best.

Preliminary findings from two uncontrolled studies in 16 and 20 patients with different types of solid tumours 45 47, and from one controlled study in 37 breast cancer patients 46, of oral all-rac-alpha-tocopherol acetate in the prevention of doxorubicin-induced alopecia, suggest that it is not effective for this condition.

Citation

Luc Geeraert, CAM-Cancer Consortium. Vitamin E during cancer treatment [online document]. http://cam-cancer.org/The-Summaries/Dietary-approaches/Vitamin-E-during-cancer-treatment. September 30, 2015.

Document history

Summary updated in September 2015 by Luc Geeraert.
Summary fully revised and updated in July 2013 by Luc Geeraert.
Summary first published in August 2011, authored by Luc Geeraert.

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