Department of Palliative Medicine, Chair of Oncology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland.
Department of Nephrology, Hypertension and Kidney Transplantation, Medical University of Lodz, ul. Pomorska 251, 92-213 Lodz, Poland.
Nutrients. 2021 Feb 26;13(3):735. doi: 10.3390/nu13030735.
High-dose intravenously administered vitamin C (IVC) is widely used in cancer patients by complementary and alternative medicine practitioners. The most frequent indications for IVC therapy result from the belief in its effectiveness as a potent anti-cancer agent which additionally enhances chemosensitivity of cancer cells and reduces chemotherapy-related toxicities and fatigue intensity. In this narrative review, we decided to deal with this issue, trying to answer the question whether there is any scientific evidence supporting the rationale for application of high-dose IVC therapy in advanced-stage cancer patients. Although results obtained from preclinical studies demonstrated that millimolar ascorbate plasma concentrations achievable only after IVC administration were cytotoxic to fast-growing malignant cells and inhibited tumor growth as well as prolonged the survival of laboratory animals, such positive effects were not found in human studies with advanced-stage cancer patients. We also have not found the rationale for the use of IVC to increase the effectiveness of chemotherapy and to reduce the chemotherapy-induced toxicity in the above mentioned group. Nevertheless, in palliative care, high-dose IVC might be considered as a therapy improving the quality of life and reducing cancer-related symptoms, such as fatigue and bone pain. However, because of the absence of placebo-controlled randomized trials on IVC efficacy in advanced-stage cancer patients, the placebo effect cannot be excluded.
高剂量静脉注射维生素 C(IVC)被补充和替代医学从业者广泛用于癌症患者。IVC 治疗最常见的适应症源于其作为一种有效的抗癌药物的有效性的信念,它还可以增强癌细胞的化疗敏感性,并降低化疗相关毒性和疲劳强度。在这篇叙述性评论中,我们决定处理这个问题,试图回答是否有任何科学证据支持在晚期癌症患者中应用高剂量 IVC 治疗的原理。尽管来自临床前研究的结果表明,只有在 IVC 给药后才能达到的毫摩尔浓度的抗坏血酸对快速生长的恶性细胞具有细胞毒性,并抑制肿瘤生长以及延长实验室动物的存活时间,但在晚期癌症患者的人体研究中并未发现这种积极作用。我们也没有找到在上述人群中使用 IVC 来提高化疗效果和降低化疗诱导毒性的原理。然而,在姑息治疗中,高剂量 IVC 可被视为改善生活质量和减轻癌症相关症状(如疲劳和骨痛)的治疗方法。然而,由于缺乏关于晚期癌症患者 IVC 疗效的安慰剂对照随机试验,不能排除安慰剂效应。