Pycnogenol may alleviate adverse effects in oncologic treatment.

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Panminerva Med. 2008
may alleviate adverse effects in oncologic treatment.

, Cesarone
, Genovesi
, Ledda
, Vinciguerra
, Ricci
, Pellegrini
, Gizzi
, Ippolito
, Dugall
, Cacchio
, Di
Renzo A
, Stuard
Vascular Labs and Physiology, Department of
Biomedical Sciences, Gabriele D'Annunzio University, Chieti-Pescara,
Chieti, Italy.

large variety of adverse reactions are well known to frequently occur
during chemotherapy and radiotherapy in oncology. Specific medications
exist to target individual side effects. The aim of this study was to
explore in a pilot trial whether supplementation with French maritime
pine bark extract Pycnogenol could alleviate side effects and improve
patient's quality of life.
METHODS: Cancer patients who previously
underwent surgery and who were in view of their pathology in relatively
good condition, both physically and psychologically, were recruited for
this study and divided into two groups. These patients received their
first cycle of radiotherapy or chemotherapy, which lasted from 10 days
up to 1 month. Then one group of patients received 150 mg Pycnogenol,
the control group comparable placebo in a single-blinded fashion. The
authors studied the occurrence of side effects and made attempts to
judge their severity on a semi-quantitative visual analogue scale over a
2 months period starting after patients completed their first cycle of
chemo- or radiotherapy, respectively.
RESULTS: Twenty five radiotherapy
patients receiving Pycnogenol showed a decreased frequency of
essentially all investigated side-effects as compared to 21 patients
receiving placebo, though in many categories the difference was limited.
The most apparent improvements of acute side effects related to
decreased soreness and ulceration in the mouth and throat as well as
less dryness of the mouth and the eyes. A decreased incidence of nausea
/vomiting, diarrhoea, edema and weakness was noticed, which was
reflected by semi-quantitative evaluation suggesting that severity was
only half or even less pronounced than in the control group. Only one
case of deep vein thrombosis occurred in the Pycnogenol group whereas 2
cases of superficial vein thromboses and one case of deep vein
thrombosis occurred in the control group (2.9% vs 10%). Thirty four
chemotherapy patients were supplemented with Pycnogenol and another 30
patients were in the control group. For all patients this was the first
chemotherapy treatment period. The Pycnogenol group presented with a
lowered incidence of all investigated side effects as compared to the
control group, though in many cases to a limited extent. The most
prominent improvements were found for nausea, vomiting, diarrhoea and
weight loss. Semi-quantitative evaluation showed that here again symptom
severity was half or less pronounced than in the control group. Various
further symptoms improved such as cognitive impairment and also
cardiotoxicity and neutropenia. Effects on anemia could not be
investigated as several patients received erythrocyte transfusion. In
the Pycnogenol group one case of superficial vein thrombosis was
indentified while 3 cases of superficial vein thromboses and one deep
vein thrombosis were detected in the control group (4% vs 19%). In both
chemotherapy and radiotherapy patients Pycnogenol lowered the
requirement for medication to address side effects. This was reflected
by less days of hospitalisation the patients required. The authors did
not investigate a possible interference with the anti-neoplastic
efficacy of chemo- and radiotherapy. This possibility requires attention
in future studies with Pycnogenol. From their previous clinical
experience the authors suggest that alleviation of side effects
described in this study results from Pycnogenol activities related to
endothelial protection, and anti-inflammatory anti-edema activities.

CONCLUSION: The results of this pilot trial warrant further prospective
studies with larger number of patients to validate benefits more
specifically with regard to type of malignancy and treatment regimen.