Cisplatin combination chemotherapy induces a fall in plasma antioxidants of cancer patients

Ann Oncol. 1998 Dec;9(12):1331-7. doi: 10.1023/a:1008407014084.


Background: Antioxidants protect the body against cellular oxidative damage and thus some of the adverse effects induced by cisplatin and other cytostatic drugs.

Patients and methods: The effect of cisplatin-combination chemotherapy on concentrations of plasma antioxidants was studied in 36 cancer patients, including osteosarcoma and testicular carcinoma patients.

Results: Eight to 15 days after the start of each cytostatic drug infusion concentrations of various plasma antioxidants were measured and compared to pretreatment values: vitamin C and E, uric acid and ceruloplasmin levels fell significantly (P < 0.01-0.005) and returned to baseline levels before the start of the next chemotherapy cycle. Levels of the antioxidants bilirubin albumin and the ratio vitamin E/cholesterol + triglycerides measured three weeks after the start of chemotherapy significantly decreased compared to pretreatment levels and remained low thereafter (P < 0.001-0.002). Dietary intake of antioxidants and anthropometric measurements, evaluated in 14 patients did not change during the whole treatment period.

Conclusions: Cisplatin-combination chemotherapy induces a fall in plasma antioxidant levels, that may reflect a failure of the antioxidant defense mechanism against oxidative damage induced by commonly used anticancer drugs. This probably results from consumption of antioxidants caused by chemotherapy induced-oxidative stress as well as renal loss of water-soluble, small molecular weight antioxidants such as uric acid.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anthropometry
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Antioxidants / analysis*
  • Ceruloplasmin / analysis
  • Cisplatin / administration & dosage
  • Cisplatin / adverse effects*
  • Copper / blood
  • Diet
  • Female
  • Glomerular Filtration Rate / drug effects
  • Hearing Loss, Sensorineural / chemically induced
  • Humans
  • Kidney / drug effects
  • Male
  • Middle Aged
  • Neoplasms / blood
  • Neoplasms / drug therapy*
  • Neoplasms / urine
  • Oxidative Stress
  • Vitamins / blood
  • beta Carotene / blood


  • Antioxidants
  • Vitamins
  • beta Carotene
  • Copper
  • Ceruloplasmin
  • Cisplatin