Supportive Care in Cancer

, Volume 21, Issue 5, pp 1359–1363 | Cite as

Antioxidant supplementation has a positive effect on oxidative stress and hematological toxicity during oncology treatment in cervical cancer patients

  • Vanessa Fuchs-Tarlovsky
  • María Amanda Casillas Rivera
  • Karolina Alvarez Altamirano
  • Juan Carlos Lopez-Alvarenga
  • Guillermo Manuel Ceballos-Reyes
Original Article


Background and aim

Hematological toxicity and oxidative stress are common in cancer patients. Antioxidant supplementation has been shown to decrease oxidative stress, but there is still controversy on this topic. The aim of this study was to determine the effect of antioxidant supplementation on oxidative stress, hematological toxicity, and quality of life (QoL) in cervical cancer patients.


Randomized, single-blinded controlled trial in women with cervical cancer treated with radiotherapy and chemotherapy with cisplatin. Subjects were randomly assigned to receive antioxidant supplement or placebo supplement. Plasma concentrations of malondialdehyde, free carbonyls, and blood biometry were measured. EORTC quality of life questionnaire was applied before and after oncology treatment. Student’s t test for independent samples and X2 for categorical variables were performed.


One hundred three patients were randomly assigned to receive treatment with antioxidants 49 (48 %) or placebo 54 (52.40 %). At the end of the oncology treatment, hemoglobin levels were maintained, and global QoL was better only in the supplemented group (p < 0.025).


Antioxidant supplementation in patients treated with chemotherapy and radiotherapy apparently decreased oxidative stress, maintained hemoglobin levels, and improved QoL; however, more studies are needed to study the long-term effect of this intervention.


Cervical cancer Oxidative stress Antioxidant therapy Hematological toxicity and quality of life (QoL) 


  1. 1.
    Instituto Nacional de Estadística, Geografía e Informática (INEGI). (2009) Datos nacionales a propósito del día mundial contra el cáncer. Report from INEGI. It is available in: Consulted in December, 2011
  2. 2.
    Shapiro WR, Young DF (1984) Neurological complications of antineoplastic therapy (Abstract). Acta Neurol Scand Supp 100:125–132Google Scholar
  3. 3.
    Green JA, Kirwan JM, Tierney JF, Symonds P, Fresco L, Collingwood M, Williams CJ et al (2001) Survival and recurrence after concomitant chemotherapy and radiotherapy for cancer of the uterine cervix: a systematic review and meta-analysis (Abstract). Lancet 358:781–786PubMedCrossRefGoogle Scholar
  4. 4.
    Luján P (2004) Radioterapia en el cáncer cérvico uterino. In: Torres-Lobatón A (ed) Cáncer ginecológico: diagnóstico y tratamiento. McGraw-Hill, México, pp 43–56Google Scholar
  5. 5.
    Lira VM (2004) Quimioterapia del cáncer cérvico uterino. In: Torres-Lobatón A (ed) Cáncer ginecológico: diagnóstico y tratamiento. McGraw-Hill, México, pp 84–85Google Scholar
  6. 6.
    Sociedad Española de Oncología Médica. Toxicidad hematológica. Inform by SEOM, 2011 (Published in January 17th, 2011). It is available in: URL:
  7. 7.
    Caro JJ, Salas M, Ward A, Goss G (2001) Anemia as an independent prognostic factor for survival in patients with cancer: a systematic, quantitative review. Cancer 91:2214–2221PubMedCrossRefGoogle Scholar
  8. 8.
    Elejalde JJ (2001) Estrés oxidativo, enfermedades y tratamientos antioxidantes. An Med Interna 18(6):326–235Google Scholar
  9. 9.
    Conklin KA (2004) Cancer chemotherapy and antioxidants. J Nutr 134(Suppl):3201–3204Google Scholar
  10. 10.
    Badajatia N, Satyam A, Singh P, Seth A, Sharma A (2010) Altered antioxidant status and lipid peroxidation in Indian patients with urothelial bladder carcinoma. Urol Oncol 28(4):360–367CrossRefGoogle Scholar
  11. 11.
    Sangeetha P, Das UN, Koratkar R, Suryaprabha P (1990) Increase in free radical generation and lipid peroxidation following chemotherapy in patients with cancer. Free Radic Biol Med 8:15–19PubMedCrossRefGoogle Scholar
  12. 12.
    Mukai FH, Goldstein BD (1979) Mutagenicity of malondialdehyde, a decomposition product of peroxidized polyunsaturated fatty acids. Science 191:868–9CrossRefGoogle Scholar
  13. 13.
    Trevisan M, Browne R, Ram M et al (2001) Correlates of markers of oxidative status in the general population. Am J Epidemiol 154:348–356PubMedCrossRefGoogle Scholar
  14. 14.
    Valko M, Rhodes CJ, Monocol J, Izakovic M, Mazur M (2006) Free radicals, metals and antioxidants in oxidative stress-induced cancer. Chem Biol Interact 160:1–40PubMedCrossRefGoogle Scholar
  15. 15.
    Chevion M, Berenshtein E, Stadtman ER (2000) Human studies related to protein oxidation: protein carbonyl content as a marker of damage (Abstract). Free Radic Res 33(Suppl):S99–108PubMedGoogle Scholar
  16. 16.
    Popadiuk S, Renke J, Wo NM et al (2006) Plasma protein peroxidation as a marker of oxidative stress intensity and antioxidant barrier activity in children who have completed treatment for neoplastic diseases. Med Wieku Rozwoj 10(3Pt 1):849–854PubMedGoogle Scholar
  17. 17.
    Dalle-Donnea I, Rossib R, Giustarinib D, Milzania A, Colombo R (2003) Protein carbonyl groups as biomarkers of oxidative stress. Clinica Chimica Acta 329:23–38CrossRefGoogle Scholar
  18. 18.
    Cecilia G, Davies KJA (1993) Dityrosine and tyrosine oxidation products are endogenous markers for the selective proteolysis of oxidatively modified red blood cell hemoglobin by (the 19 S) proteasome. J Biol Chem 268(12):8725–8759Google Scholar
  19. 19.
    Ladas EJ, Jacobson JS, Kennedy DD et al (2004) Antioxidants and cancer therapy: a systematic review. J Clin Oncol 22:517–528PubMedCrossRefGoogle Scholar
  20. 20.
    Block KI, Koch AC, Mead MN, Tothy PK, Newman RA, Gyllenhaal C (2007) Impact of antioxidant supplementation on chemotherapeutic efficacy: a systematic review of the evidence from randomized controlled trials. Cancer Treat Rev 33:407–418. doi:10.1016/j.ctrv.2007.01.005 PubMedCrossRefGoogle Scholar
  21. 21.
    Block KI, Koch AC, Mead MN, Tothy PK, Newman RA, Gyllenhaal C (2008) Impact of antioxidant supplementation on chemotherapeutic toxicity: a systematic review of the evidence from randomized controlled trials. Int J Cancer 123:1227–1239. doi:10.1002/ijc.237544 PubMedCrossRefGoogle Scholar
  22. 22.
    Milligan SA, Owens MW, Grisham MB (1996) Augmentation of cytokine-induced nitric oxide synthesis by hydrogen peroxide. Am J Physiol 271:L114–L120PubMedGoogle Scholar
  23. 23.
    Chandel NS, McClintock DS, Feliciano CE, Wood TM, Melendez JA, Rodriguez AM, Schumacker PT (2000) Reactive oxygen species generated at mitochondrial complex III stabilize hypoxiainducible factor-1α during hypoxia: a mechanism of O2 sensing. J Biol Chem 275:25130–25138PubMedCrossRefGoogle Scholar
  24. 24.
    Richard DE, Berra E, Pouyssegur J (2000) Nonhypoxic pathway mediates the induction of hypoxia-inducible factor 1 α in vascular smooth muscle cells. J Biol Chem 275:26765–26771PubMedGoogle Scholar
  25. 25.
    Grogan M, Thomas GM, Melamed I, Wong FLW, Pearcey RG, Joseph PK et al (1999) The importance of hemoglobin levels during radiotherapy for carcinoma of the cervix. Cancer 86:1528–36PubMedCrossRefGoogle Scholar
  26. 26.
    Yeh CC, Lai CY, Hsieh LL, Tang R, Wu FY, Sung FC (2010) Protein carbonyl levels, glutathione S-transferase polymorphisms and risk of colorectal cancer. Carcinogenesis 31(2):228–233. doi:10.1093/carcin/bgp286 PubMedCrossRefGoogle Scholar
  27. 27.
    Sinha D, Roy S, Roy M (2010) Antioxidant potential of tea reduces arsenite induced oxidative stress in Swiss albino mice (Abstract). Food Chem Toxicol 48(4):1032–1039, e-pub 2010 Jan 21PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Vanessa Fuchs-Tarlovsky
    • 1
    • 2
  • María Amanda Casillas Rivera
    • 3
  • Karolina Alvarez Altamirano
    • 4
  • Juan Carlos Lopez-Alvarenga
    • 1
  • Guillermo Manuel Ceballos-Reyes
    • 2
  1. 1.Servicio de OncologíaHospital General de MéxicoMexico D. F.Mexico
  2. 2.Escuela Superior de MedicinaInstituto Politécnico NacionalMexico CityMexico
  3. 3.Universidad IberoamericanaMéxico D. F.Mexico
  4. 4.Universidad Autónoma de Nuevo LeónMonterreyMexico

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