Antioxidanten - vitamines bewijzen levensverlengende effect - verdubbeling van levensduur van 2 jaar naar 4,3 jaar - bij niet-klein-cellige longkanker en verbeteren aanzienlijk kwaliteit van leven

17 november 2005: Bron: Lung Cancer. 2005 Jul;49(1):77-84. en Nutr Cancer. 2005;51(1):7-12

Een grote langjarige cohort studie bewijst het hoog significante effect van gebruik van bepaalde voedingssuplementen bij niet-klein-cellige longkankerpatiënten. De mediane overlevingstijd ging bij de groep die vrijwillig en zelf betalend waarschijnlijk extra voedingsupplementen en waarschijnlijk ook gezonde voeding gebruikte van 2,0 jaar naar 4,3 jaar. Ook de kwaliteit van leven was aanzienlijk beter. Een kleinere cohort studie bij niet-klein-cellige longkankerpatiënten met zelfde uitgangspunten gaf een bijna nagenoeg zelfde positieve effect te zien voor de groep van vitamines/mineralen gebruikers. Onderaan het abstract van de kleinere studie en hier de resultaten uit de grotere studie, uitgevoerd aan de bekende Mayo Clinic, Rochester, USA, zo goed als letterlijk vertaald:

RESULTATEN: Een totaal van 1129 patienten of hun volmachten beantwoorden de vitamine/mineralen vragenlijst. 714 van hun waren vitamine-mineralen gebruikers van of multivitamines of andere specifieke vitamine-mineralen en de rest waren niet gebruikers. Mediane overleving was 4.3 jaar versus 2.0 jaar voor de vitamines/mineralen gebruikers en niet-gebruikers respectievelijk. Een Cox proportional hazards model toonde een relatief risico op sterfte van 0.74 (95% confidence interval (CI): 0.44, 0.65) (p < 0.01) ten faveure van vitamines/mineralen gebruik na in achtneming van meervoudige prognostische factoren, inclusief stadium van de kanker en tumorgrootte. De Long Kancer Symtoom Schaal (LCSS) toonde betere kwaliteit van leven onder vitamine/mineralen gebruikers (hoofd verschil in score van 3 (95% CI: 0.8, 5.1) (p < 0.01); en na in achtneming van gerelateerde variabelen, bleef er een trend in positief efect voor het vitamines/mineralen gebruik met een verschil van 1.8 (95% CI: 0.2, 3.9) (p = 0.08).

CONCLUSIES: Vitamines/mineralen suppletie wordt geassocieerd met betere overleving en kwaliteit van leven in deze groep van NSCLC - niet-klein-cellige longkankerpatiënten. Toekomstige prospectieve studies zouden moeten focussen op de rol van zulke supplementen bij patiënten met NSCLC niet-klein-cellige longkanker.

Lung Cancer. 2005 Jul;49(1):77-84

Is voluntary vitamin and mineral supplementation associated with better outcome in non-small cell lung cancer patients? Results from the Mayo Clinic lung cancer cohort.

Jatoi A, Williams B, Nichols F, Marks R, Aubry MC, Wampfler J, Finke EE, Yang P.
Department of Oncology, Mayo Clinic, Rochester, MN 55905, USA.

BACKGROUND: Some previous studies report that 80% of cancer patients take multivitamin and/or mineral supplements. To our knowledge, the consequences of such self-directed supplementation have not been examined previously in non-small cell lung cancer (NSCLC) patients. The goal of this study was to determine whether vitamin/mineral supplementation is associated with improved survival and quality of life in a cohort of NSCLC patients.

METHODS: NSCLC patients or their proxies who responded to a questionnaire on vitamin/mineral use were assessed for survival and quality of life.

RESULTS: A total of 1129 patients or their proxies responded to a vitamin/mineral questionnaire. Seven hundred and fourteen were vitamin/mineral users of either multivitamins or other specific vitamin/mineral supplements, and the rest non-users. Median survival was 4.3 years versus 2.0 years for vitamin/mineral users and non-users, respectively. A Cox proportional hazards model showed a relative risk of death of 0.74 (95% confidence interval (CI): 0.44, 0.65) (p < 0.01) in favor of vitamin/mineral use after adjustment for multiple prognostic factors, including tumor stage. The Lung Cancer Symptom Scale (LCSS) showed better quality of life among vitamin/mineral users (mean difference in score of 3 (95% CI: 0.8, 5.1) (p < 0.01); and after adjusting for related variables, there remained a trend in favor of vitamin/mineral use mean difference 1.8 (95% CI: 0.2, 3.9) (p = 0.08).

CONCLUSIONS: Vitamin/mineral supplementation is associated with better survival and quality of life in this cohort of NSCLC patients. Future prospective clinical trials should focus on the role of such supplements in patients with NSCLC.

PMID: 15949593 [PubMed - in process]

Nutr Cancer. 2005;51(1):7-12.

Exploring vitamin and mineral supplementation and purported clinical effects in patients with small cell lung cancer: results from the Mayo Clinic lung cancer cohort.

Jatoi A, Williams BA, Marks R, Nichols FC, Aubry MC, Wampfler J, Yang P.

Department of Oncology, Mayo Clinic, Rochester, Minnesota 55905, USA. jatoi.aminah@mayo.edu

Previous laboratory and pilot clinical trial data suggest that vitamin and/or mineral supplementation may prevent tumor growth in small cell lung cancer. However, rates of supplementation and their major purported clinical effects have never before been studied in patients with small cell lung cancer. This study was undertaken to explore associations between vitamin/mineral supplementation and survival and quality of life within a cohort of small cell lung cancer patients. This study focused on a small cell lung cancer patient cohort from a tertiary care medical center. Small cell lung cancer patients who responded to a follow-up questionnaire on vitamin/mineral use were included. Associations between vitamin/mineral use and both survival and quality of life (Lung Cancer Symptom Scale) were assessed. A total of 178 patients or their proxies responded to one or more vitamin/mineral questionnaires. One hundred seven (60%) were vitamin/mineral users of either multivitamins or other more specific vitamin/mineral supplements, and the rest were nonusers. Two different survival analyses were performed. In the first, median survival was 1.8 vs. 1.3 yr for vitamin/mineral users and nonusers, respectively. The relative risk of death was 0.63 (95% confidence interval : 0.43, 0.92; P = 0.02) in favor of vitamin/mineral use. After adjustment for multiple prognostic factors, including tumor stage, the relative risk for death was 0.65 (95% CI: 0.43, 1.00; P = 0.05). The second analysis was based on an alternative definition of vitamin/mineral use and showed only a trend to suggest an association between vitamin/mineral use and improved survival (P = 0.09). There were no significant improvements in quality of life in any of the analyses. Vitamin/mineral supplementation is common within this cohort of small cell lung cancer patients. These data suggest an association between vitamin/mineral supplementation and improved survival and point to a need for future studies on vitamin and mineral supplementation in small cell lung cancer patients.

PMID: 15749624 [PubMed - indexed for MEDLINE]