Intravenous Vitamin C and Cancer: A Systematic Review
Intravenous Vitamin C and Cancer: A Systematic Review
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DOI：
10.1177/1534735414534463
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发表时间：
2014-07-01
影响因子：
2.9
通讯作者：
Seely, Dugald
中科院分区：
文献类型：
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作者：
Fritz, Heidi;Flower, Gillian;Seely, Dugald
背景静脉注射维生素C（IVC）是一种有争议的抗癌疗法，广泛用于自然疗法和综合肿瘤学环境。我们对评估IVC用于癌症患者的人类干预性和观察性研究进行了系统性综述。方法.我们检索了MEDLINE、EMBASE、The科克伦图书馆、CINAHL和AMED从开始到2013年4月的人类研究，以检查IVC在癌症患者中使用的安全性、有效性或药代动力学。结果在897份记录中，共纳入了37项研究的39份报告：2项随机对照试验（RCT）、15项非对照试验、6项观察性研究和14份病例报告。IVC给药范围为每次输注1 g至超过200 g抗坏血酸，通常每周给药2至3次。IVC似乎不会增加毒性或干扰吉西他滨/厄洛替尼治疗或紫杉醇和卡铂的抗肿瘤作用。基于1项随机对照试验和非对照人体试验的数据，IVC与化疗联合使用可能会缩短复发时间，并可能促进肿瘤肿块缩小，提高生存率。IVC可以改善生活质量、身体功能和与化疗相关的毒性，包括疲劳、恶心、失眠、便秘和抑郁。病例报告记录了与使用IVC相关的肿瘤消退和长期无病生存的几个实例。结论关于IVC安全性和有效性的高质量临床证据有限。现有证据是初步的，不能被认为是结论性的，但表明具有良好的安全性特征和潜在的重要抗肿瘤活性;然而，需要更严格的证据来最终证明这些作用。IVC可以改善癌症患者的生活质量和症状严重程度，并且已经报道了几例癌症缓解病例。需要设计良好的IVC治疗对照研究。
Background. Intravenous vitamin C (IVC) is a contentious adjunctive cancer therapy, widely used in naturopathic and integrative oncology settings. We conducted a systematic review of human interventional and observational studies assessing IVC for use in cancer patients. Methods. We searched MEDLINE, EMBASE, The Cochrane Library, CINAHL, and AMED from inception to April 2013 for human studies examining the safety, effectiveness, or pharmacokinetics of IVC use in cancer patients. Results. Of 897 records, a total of 39 reports of 37 studies were included: 2 randomized controlled trials (RCTs), 15 uncontrolled trials, 6 observational studies, and 14 case reports. IVC dosing ranged from 1 g to more than 200 g ascorbic acid per infusion, typically administered 2 to 3 times weekly. IVC does not appear to increase toxicity or interfere with antitumor effects of gemcitabine/erlotinib therapy or paclitaxel and carboplatin. Based on 1 RCT and data from uncontrolled human trials, IVC may improve time to relapse and possibly enhance reductions in tumor mass and improve survival in combination with chemotherapy. IVC may improve quality of life, physical function, and toxicities associated with chemotherapy, including fatigue, nausea, insomnia, constipation, and depression. Case reports document several instances of tumor regression and long-term disease-free survival associated with use of IVC. Conclusion. There is limited high-quality clinical evidence on the safety and effectiveness of IVC. The existing evidence is preliminary and cannot be considered conclusive but is suggestive of a good safety profile and potentially important antitumor activity; however, more rigorous evidence is needed to conclusively demonstrate these effects. IVC may improve the quality of life and symptom severity of patients with cancer, and several cases of cancer remission have been reported. Well-designed, controlled studies of IVC therapy are needed.