Glutathione reduces the toxicity and
improves quality of life of women diagnosed with ovarian cancer treated with
cisplatin: results of a double-blind, randomised trial.
ICRF Medical Oncology Unit, Western General Hospital, Edinburgh, UK.
BACKGROUND: Early clinical trials have suggested that glutathione (GSH) offers
protection from the toxic effects of cisplatin. PATIENTS AND METHODS: One
hundred fifty-one patients with ovarian cancer (stage I-IV) were evaluated in a
clinical trial of cisplatin (CDDP) +/- glutathione (GSH). The objective was to
determine whether GSH would enhance the feasibility of giving six cycles of
CDDP at 100 mg/m2 without dose reduction due to toxicity. RESULTS: When
considering the proportion of patients receiving six courses of CDDP at any
dose, GSH produced a significant advantage over control--58% versus 39%, (P =
0.04). For these patients there was a significant difference between the
reduction in creatinine clearance for GSH treated patients compared with
control--74% versus 62% (P = 0.006). Quality of life scores demonstrated that
for patients receiving GSH there was a statistically significant improvement in
depression, emesis, peripheral neurotoxicity, hair loss, shortness of breath
and difficulty concentrating. As an indication of overall activity, these
patients were statistically significantly more able to undertake housekeeping
and shopping. Clinically assessed response to treatment demonstrated a trend
towards a better outcome in the GSH group (73% versus 62%) but this was not
statistically significant (P = 0.25). CONCLUSIONS: The results demonstrate that
adding GSH to CDDP allows more cycles of CDDP treatment to be administered
because less toxicity is observed and the patient's quality of life is
improved.
