A pilot study of the impact of Vitamin C supplementation with neoadjuvant chemoradiation on regulators of inflammation and carcinogenesis in esophageal cancer patients

J Cancer Res Ther. 2019 Jan-Mar;15(1):185-191. doi: 10.4103/jcrt.JCRT_763_16.

Abstract

Aims: Vitamin C plays a role in chemoprevention in cancer treatment, and Vitamin C modulates many regulators of inflammation in in vitro studies. The aim of this study is to assess the effect of Vitamin C supplementation with neoadjuvant chemoradiation in esophageal adenocarcinoma on the nuclear factor-kappa B (NF-κB) and associated cytokines.

Materials and methods: A total of 20 patients undergoing multimodal treatment for esophageal adenocarcinoma were randomized to receive Vitamin C (1000 mg/day) orally for 4 weeks or no supplementation. Pre- and post-Vitamin C endoscopic biopsies were used for the study of NF-κB activity and cytokine analysis.

Results: NF-κB activity along with cytokines was activated in the cancer tissue pretreatment. Down-regulation in NF-κB activity was observed in 25% of cases, two from the Vitamin C arm posttreatment. There was a significant reduction in cytokines levels in the cancer group, and this effect was more pronounced in the Vitamin C group (P < 0.05).

Conclusions: Vitamin C supplementation had a mild protective effect in modulating of regulators of inflammation and carcinogenesis. Further studies with larger numbers of endpoints are needed to evaluate its effect on modulation of chemoradiation responses.

Keywords: Cytokines; Vitamin C; esophageal cancer; neoadjuvant chemoradiation; nuclear factor-kappa B.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adenocarcinoma / diagnostic imaging
  • Adenocarcinoma / pathology
  • Adenocarcinoma / therapy*
  • Aged
  • Ascorbic Acid / administration & dosage*
  • Biopsy
  • Carcinogenesis / drug effects*
  • Carcinogenesis / pathology
  • Carcinogenesis / radiation effects
  • Chemoradiotherapy / methods
  • Cytokines / metabolism
  • Dietary Supplements*
  • Esophageal Mucosa / diagnostic imaging
  • Esophageal Mucosa / drug effects
  • Esophageal Mucosa / pathology
  • Esophageal Mucosa / radiation effects
  • Esophageal Neoplasms / diagnostic imaging
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / therapy*
  • Esophagectomy
  • Esophagoscopy
  • Female
  • Humans
  • Inflammation / diagnostic imaging
  • Inflammation / pathology
  • Inflammation / therapy*
  • Male
  • Middle Aged
  • NF-kappa B / metabolism
  • Neoadjuvant Therapy / methods
  • Pilot Projects
  • Treatment Outcome

Substances

  • Cytokines
  • NF-kappa B
  • Ascorbic Acid

Supplementary concepts

  • Adenocarcinoma Of Esophagus