الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Breast cancer is by far the most common cancer among women worldwide. It is also the leading cause of cancer death in females since annually, 400,000 women die from this disease. In Egypt, breast cancer is estimated to be the most common cancer among females accounting for 37.7% of their total 12,621 with new cases in 2008. It is also the leading cause of cancer related mortality accounting for 29.1% of their total with 6546 deaths. The incidence to mortality ratio is poor (1.9:1). The etiology of breast cancer is multifactorial and several risk factors associated with breast cancer may exert their effects via generation of an oxidative stress status.
Most patients with breast cancer are treated with a combination of the anticancer chemotherapy drugs of 5-fluorouracil, doxorubicin, and cyclophosphamide (FAC). Chemotherapy agents act through various oxidative stress mechanisms to produce free radicals that damage tumor cells. Oxidative stress during cancer therapy also harms healthy tissue. It is possible that taking antioxidant supplements during treatment can protect normal tissues from the damaging of side effects of treatments, and may improve tumor response and patient survival. However, antioxidant supplementation during conventional chemotherapy and radiation therapy is a controversial subject. Some studies suggest taking antioxidants supplements during treatment may be beneficial; however, there are just as many studies that tell us this may be harmful. The scientific evidence on this topic is not strongly for or against taking antioxidant supplements during cancer treatment.
Accordingly the present study is undertaking to explore whether vitamin A and E supplementation during 5-fluorouracil, doxorubicin, and cyclophosphamide (FAC) therapy will have its impact on chemotherapy-induced oxidative stress.
This study is carried out, after the approval of Ethics Committee – Medical Research Institute, on 45 breast cancer patients who were divided into two groups; group (I) which was subjected only to chemotherapy (20 patients) and group (II) which was subjected to chemotherapy plus supplementation with vitamin A and E(25 patients). Markers of oxidative stress including serum MDA, β-carbonyl protein (β -CP) and total antioxidant capacity (TAOC) are measured in patients of those two groups before and after chemotherapy with or without vitamins supplement.
In group (I), vitamins supplemented -ve, the results showed that chemotherapy with FAC resulted in a significant elevation in MDA and β-CP accompanied by a significant decrease in TAOC. These results may indicate that breast cancer patients are subjected to oxidative stress which is manifested by elevation in free radicals production and decreased antioxidant capacity. The developed oxidative stress may have its impact on the breast cancer patients render them subjected to different side effects including chronic fatigue which is the most common side effects.
In group II, vitamins supplemented +ve, and after chemotherapy, while, the mean concentration levels of MDA and β-CP were significantly reduced, the mean total antioxidant capacity level was significantly elevated. Moreover, in group II after chemotherapy and vitamin supplementation, the mean concentration levels of MDA and β-CP were significantly reduced when compared to those in group I after chemotherapy. The observed reduction in free radical production and the interesting increase in total antioxidant capacity level could be attributed to the antioxidant properties of both vitamins A and E. The improvement in oxidative status in those patients may reduce side effects of chemotherapy agents and might result in an improved quality of life for the patient, and possibly better survival rates.
In conclusion; the present study is an attempt to through more lights on the beneficial effects of providing breast cancer patients with antioxidant vitamins as vitamin A and vitamin E during chemotherapy. Thus, as shown in the present study, the ability of these vitamins to reduce oxidative stress in breast cancer patients during chemotherapy and its subsequent impacts may lead to recommend supplementation of breast cancer patients with antioxidant vitamins as vitamin A and vitamin E during chemotherapy. Also, it is recommended to evaluate the levels of these vitamins in sera of breast cancer patients before and during chemotherapy.