Vitamine A (30.000 IU), vitamine C 1 gram en vitamine E 70 mg dagelijks verlaagt bij patiënten met eerder darmadenomen tov placebo de kans op een nieuw adenoom

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9 augustus 2005: Bron: Dis Colon Rectum. 1993 Mar;36(3):227-34.

De combinatie van dagelijks vitamine A (30.000 IU), vitamine C 1 gram en vitamine E 70 mg verlaagt bij patiënten met darmadenomen in de voorgeschiedenis (verdachte poliepen waren verwijderd door operatieve ingreep) tov placebo de kans op een nieuw adenoom met circa 85%. Het verschil was dat bij 5.7 procent in de suppletiegroep zich een recidief voordeed en bij 35.9% in de placebogroep kregen mensen een recidief.. Dit blijkt uit een al in 1993 gepubliceerde gerandomiseerde studie bij 255 deelnemende patiënten. We moeten er wel bij aantekenen dat van de 255 personnen er maar liefst 34 personen zich niet hielden aan de schema's of domweg niet meer kwamen opdagen bij een folluw-up.

Antioxidant vitamins or lactulose for the prevention of the recurrence of colorectal adenomas. Colorectal Cancer Study Group of the University of Modena and the Health Care District 16.

Roncucci L, Di Donato P, Carati L, Ferrari A, Perini M, Bertoni G, Bedogni G, Paris B, Svanoni F, Girola M, et al.
Istituto di Patologia Medica, Modena, Italy.

Colonic adenomas represent the natural precursor lesions of most colorectal cancers. The treatment of choice is endoscopic polypectomy. However, after endoscopic removal, polyps recur in a large fraction of cases. Thus, we evaluated the effect of antioxidant vitamins or lactulose on the recurrence rate of adenomatous polyps. After polypectomy, 255 individuals were randomized into three groups. Group 1 was given vitamin A (30,000 IU/day), vitamin C (1 g/day), and vitamin E (70 mg/day); Group 2 was given lactulose (20 g/day); Group 3 received no treatment. Forty-six subjects had to be excluded because the histologic diagnosis was not consistent with adenoma. The remaining 209 individuals were included in the analysis according to the "intention to treat" criterion, though 34 did not adhere to the scheduled treatment or were lost during the follow-up. Subjects were followed at regular intervals for an average of 18 months. Polyps recurring before one year from index colonoscopy were considered missed by the endoscopist. In the 209 evaluable subjects, the percentages of recurrence of adenomas were 5.7 percent, 14.7 percent, and 35.9 percent in the vitamins, lactulose, and untreated groups, respectively. The fraction of subjects remaining free of adenomas, estimated by Kaplan-Meier survival curves, was significantly different among the three groups (log-rank chi-squared = 17.138; P < 0.001). Using Cox's regression analysis, treatment was the only variable that significantly contributed to the model (regression coefficient = 0.905; P < 0.001). In conclusion, either antioxidant vitamins or, to a lesser extent, lactulose lower the recurrence rate of adenomas of the large bowel and can be proposed as chemopreventive agents, at least in high-risk individuals.

Publication Types:
Clinical Trial
Randomized Controlled Trial

PMID: 8449125 [PubMed - indexed for MEDLINE]

spijsverteringskanker, darmkanker, vitamines