Impact of combining vitamin C with radiation therapy in human breast cancer: does it matter?
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Somayeh Khazaei1,2, Linn Nilsson1,3,4, Gabriel Adrian1,2, Helga Tryggvadottir1,2, Elise Konradsson5, Signe Borgquist1,6, Karolin Isaksson7,8, Crister Ceberg5 and Helena Jernström1
1 Division of Oncology, Clinical Sciences in Lund, Lund University and Skåne University Hospital, Lund, Sweden
2 Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
3 Department of Medical Physics and Engineering, Växjö Central Hospital, Växjö, Sweden
4 Department of Research and Development, Region Kronoberg, Växjö, Sweden
5 Department of Clinical Sciences in Lund, Medical Radiation Physics, Lund University, Lund, Sweden
6 Department of Oncology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
7 Division of Surgery, Department of Clinical Sciences in Lund, Lund University, Lund, Sweden
8 Department of Surgery, Kristianstad Hospital, Kristianstad, Sweden
Keywords: human breast cancer; radiation therapy; vitamin C;
Received: January 25, 2022 Accepted: February 14, 2022 Published: February 22, 2022
Vitamin C may impact the efficiency of radiation therapy (RT) in breast cancer. The effects of RT alone or in combination with vitamin C in SKBR3, MDA-MB-231, and MCF7 cells were compared using clonogenic assay, proliferation assay (MTT), cell cycle analysis, and Western blot. Vitamin C use was assessed in 1803 breast cancer patients 2002–2017 in relation to clinicopathological features and recurrences after RT. Vitamin C combined with RT resulted in non-significant increases in colony formation and minor differences in cell cycle arrest and expression of studied proteins, compared to RT alone. Lower vitamin C doses alone or in combination with RT, resulted in higher proliferation with MTT than higher vitamin C doses in a cell line-dependent manner. Vitamin C use was associated with lower histological grade and BMI but not recurrence risk in RT-treated patients (LogRank P = 0.54). Vitamin C impacted RT efficiency differently depending on breast cancer subtype and vitamin C concentration. Lower doses of vitamin C, achievable with oral administration, might increase breast cancer cell proliferation and decrease radiosensitivity. Despite vitamin C users having less aggressive tumors than non-users, the recurrence risk in RT-treated patients was similar in vitamin C users and non-users.
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