AUTHOR=Chen Jie , Shan Haili , Yang Wenjun , Zhang Jiali , Dai Haibin , Ye Ziqi 

TITLE=Vitamin E for the Prevention of Chemotherapy-Induced Peripheral Neuropathy: A meta-Analysis

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2021.684550

DOI=10.3389/fphar.2021.684550

ISSN=1663-9812

ABSTRACT=Background: Vitamin E has been increasingly used to prevent chemotherapy-induced peripheral neuropathy (CIPN) in recent years. However, it is still unclear whether vitamin E can effectively prevent CIPN. 
Methods: We searched all clinical studies in the Embase, Cochrane Library, Clinicaltrials.gov, and PubMed databases from inception to December 2020. We performed a meta-analysis of 9 randomized controlled trials (RCTs) with 486 patients that compared the vitamin E group with the control group. Outcomes of the study were incidence of all-grade CIPN, incidence of severe CIPN, and the total neuropathy scores (TNS). Random effect models were used to make the meta-analysis results more cautious. 
Results: Notably, vitamin E significantly reduced the incidence of all-grade CIPN (overall risk ratio (RR)=0.55, 95%CI: 0.36, 0.85, I2=77.3%, P=0.007), and TNS (overall standard mean difference (SMD)=-0.64, 95%CI: -1.03, -0.25, I2=42.7%, P=0.001). However, the results of the subgroup analysis, which included only double-blind RCTs, suggested that vitamin E did not significantly reduce the incidence of all-grade CIPN (overall RR=0.52, 95%CI: 0.07, 4.06, I2=77.5%, P=0.531). Moreover, there was no significant difference in the incidence of severe CIPN between these two arms (P=0.440). 
Conclusions: The results of our meta-analysis suggests that vitamin E has a beneficial effect on the incidence and symptoms of CIPN. However, routine prophylactic use of vitamin E is still not recommended. Moreover, more high-quality double-blind RCTs are needed to further validate the effects of vitamin E in prevention of CIPN.