Clinical efficacy and safety of oral and intravenous vitamin C use in patients with malignant diseases

J Cancer Res Clin Oncol. 2021 Oct;147(10):3025-3042. doi: 10.1007/s00432-021-03759-4. Epub 2021 Aug 17.

Abstract

Background: Vitamin C, also called ascorbic acid, is a water-soluble antioxidant and free radical scavenger. It is required in the body for numerous metabolic functions and is involved in the development of proteins and connective tissue.

Methods: In April 2020, a systematic search was carried out on five electronic databases (Medline, Embase, Cochrane, Cinahl, PsycINFO) to find studies on the use, efficacy and safety of a complementary therapy with vitamin C in oncological patients.

Results: Out of the initial 23,195 search results, 21 studies with 1961 patients were included in this review. Five of the included studies (n = 417) were randomized controlled trials (RCTs). The remaining 16 studies belonged to a lower class of evidence. The patients who were treated with vitamin C suffered from various malignant diseases, some in an advanced and palliative stage. Vitamin C was applied intravenously or orally. It was either the only treatment or was combined with chemo- or radiotherapy. Endpoints included the development of the disease-related symptoms, quality of life, mortality, progression-free survival and safety of vitamin C. The studies were of moderate quality and showed either no effect of vitamin C or a positive trend, although this has rarely been statistically proven in group comparisons. No or only slight side effects with both oral and intravenous administration of vitamin C were reported.

Conclusion: Oral intake of vitamin C does not appear to have any effect in patients with malignancies. Data are heterogeneous for intravenous administration. There are no RCTs with statistical group comparisons.

Keywords: Ascorbic acid; Cancer; Complementary medicine; Safety; Vitamin C.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Antioxidants / administration & dosage*
  • Ascorbic Acid / administration & dosage*
  • Humans
  • Injections, Intravenous
  • Neoplasms / drug therapy*
  • Prognosis

Substances

  • Antioxidants
  • Ascorbic Acid

Grants and funding