Abstract
Melatonin (MLT) has been proven to counteract chemotherapy toxicity, by acting as
an anti-oxidant agent, and to promote apoptosis of cancer cells, so enhancing chemotherapy
cytotoxicity. The aim of this study was to evaluate the effects of concomitant MLT
administration on toxicity and efficacy of several chemotherapeutic combinations in
advanced cancer patients with poor clinical status. The study included 250 metastatic
solid tumour patients (lung cancer, 104; breast cancer, 77; gastrointestinal tract
neoplasms, 42; head and neck cancers, 27), who were randomised to receive MLT (20 mg/day orally every day) plus chemotherapy, or chemotherapy alone. Chemotherapy consisted
of cisplatin (CDDP) plus etoposide or gemcitabine alone for lung cancer, doxorubicin
alone, mitoxantrone alone or paclitaxel alone for breast cancer, 5-FU plus folinic
acid for gastro-intestinal tumours and 5-FU plus CDDP for head and neck cancers. The
1-year survival rate and the objective tumour regression rate were significantly higher
in patients concomitantly treated with MLT than in those who received chemotherapy
(CT) alone (tumour response rate: 42/124 CT+MLT versus 19/126 CT only, P<0.001; 1-year survival: 63/124 CT+MLT versus 29/126 CT only, P<0.001). Moreover, the concomitant administration of MLT significantly reduced the
frequency of thrombocytopenia, neurotoxicity, cardiotoxicity, stomatitis and asthenia.
This study indicates that the pineal hormone MLT may enhance the efficacy of chemotherapy
and reduce its toxicity, at least in advanced cancer patients of poor clinical status.
Keywords
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Article info
Publication history
Accepted:
June 20,
1999
Received in revised form:
May 24,
1999
Received:
February 22,
1999
Identification
Copyright
© 1999 Elsevier Science Ltd. Published by Elsevier Inc. All rights reserved.
