Kottschade, L.A., Sloan, J.A., Mazurczak, M.A., Johnson, D.B., Murphy, B.P., Rowland, K.M., . . . Loprinzi, C.L. (2011). The use of vitamin E for the prevention of chemotherapy-induced peripheral neuropathy: Results of a randomized phase III clinical trial. Supportive Care in Cancer, 19, 1769–1777.

The aim of the study was to evaluate the efficacy of Vitamin E for the prevention of chemotherapy-induced peripheral neuropathy.

Patients who were to receive taxane or platinum-based chemotherapy were randomized to receive placebo or vitamin E 300 mg by mouth twice daily. Treatment was begun within four days of the first chemotherapy treatment and continued throughout treatment and for one month beyond completion of chemotherapy. Patient assessments were conducted at baseline, prior to each chemotherapy treatment, and at one and six months after chemotherapy.

• The total sample consisted of 189 participants, 82% female and 18% male.
• Sixty-one percent of the total sample were older than age 50 years.
• Participants had multiple tumor types. Breast cancer was most common (61%).
• Ninety-four percent were Caucasian. 
• Fifty-eight percent were receiving taxane and the rest were receiving a platinum-based compound.
• Patients were excluded if anticoagulatns, opiods, anticonvulsants, or other treatments were used for neuropathic pain.
   

The study was conducted at multiple outpatient locations that were part of the North Central Cancer Treatment Group.

Phase of care

• Active antitumor treatment

The study had a double blind,  randomized, placebo-controlled trial design.

• NCI-CTCAE, version 3.0
• Symptom experience diary
• Neuropathic-specific questions
   

 No significant differences were noted between groups regarding study outcomes.

The findings do not demonstrate an effect of Vitamin E oral supplements on peripheral neuropathy from chemotherapy.

• Measurement and methods were not well described.
• Measurement validity and reliability was questionable.
• Use and frequency of the patient diary are not well described.
• There were no objective measures of neuropathy. 
• No recognized self-report questionnaire was used.

 Findings do not support the use of Vitamin E to prevent chemotherapy-induced peripheral neuropathy. Nurses can guide patients regarding the evidence in this area.