Research Papers:

Impact of combining vitamin C with radiation therapy in human breast cancer: does it matter?

Somayeh Khazaei _, Linn Nilsson, Gabriel Adrian, Helga Tryggvadottir, Elise Konradsson, Signe Borgquist, Karolin Isaksson, Crister Ceberg and Helena Jernström _

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Oncotarget. 2022; 13:439-453. https://doi.org/10.18632/oncotarget.28204

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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

Correspondence to:

Helena Jernström, email: [email protected]
Somayeh Khazaei, email: [email protected]

Keywords: human breast cancer; radiation therapy; vitamin C; in vitro; clinical outcome

Received: January 25, 2022     Accepted: February 14, 2022     Published: February 22, 2022

Copyright: © 2022 Khazaei et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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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