Abstract
Aim: The aim of this study was to evaluate the efficacy and
side effects of silymarin in the treatment of chemotherapy-induced
peripheral neuropathy (CIPN).
Methods: Patients who referred to outpatient oncology
department of a referral educational hospital affiliated to Mazandaran
University of Medical Sciences and experienced CIPN were randomized to
receive silymarin or placebo. Intervention group received 140 mg of the
Silymarin twice daily accompanied and 300 mg/day Gabapentin, whereas
control group received 300 mg/day of Gabapentin and placebo twice daily
for 3 months. The grade of neuropathy was determined according to the
CTCAE criterion. The improvement of neuropathy was defined as the
reduction of at least one neuropathic score. The visual analogue scale
(VAS) was used to assess the severity of patients’ pain and the
EORTC-QLQ-C30 criterion was used to assess the quality of life. Patients
were evaluated initially and at the follow up visit 3 months after the
enrollment.
Results: A total of 80 patients were enrolled in the study.
There was no significant difference between the groups in terms of
severity of neuropathy at baseline. At the end of the study, the number
of people with improved neuropathy in the silymarin group was 82.8%
patients, which was significantly higher than 48.4% observed in the
patients received placebo (P= 0.005). The silymarin-treated group showed
a significant reduction in pain compared with those receiving placebo.
Despite the improvement in quality of life in the intervention group
compared to the comparison group, this difference was not statistically
significant. Gastrointestinal symptoms were the only reported side
effects with a similar incidence in two groups.
Conclusion: The present data demonstrate the potential clinical
use of silymarin as an adjuvant therapy to reduce CIPN symptoms.
Keywords: Silymarin, Chemotherapy-induced peripheral neuropathy
(CIPN), Inflammation, Platinum, Taxanes, Vinca alkaloids