Multivitamins
Three investigations evaluated multivitamin supplementation in CiO(Weijl
et al., 2004, Villani et al., 2016, Scasso et al., 2017). A multivitamin
beverage that contained vitamin C, vitamin E, and selenium was used as
CiO profilaxis in a RCT. At 12 months they did not find any difference
between the occurrence of nephrotoxicity and ototoxicity induced by
cisplatin. However, patients with the highest micronutrient antioxidant
values at the start of chemotherapy had significantly less loss of
high-tone hearing than patients with low values (conduction threshold at
8.0 kHz 2.8 vs. 14.4 dB; p=0.028)(Weijl et al., 2004). Another RCT
compared the protective effect of vitamin E supplementation for 3 months
against placebo in CiO. At 1 month the control group had significant
hearing loss at both 2000 Hz (right ear: p=0.05; left ear: p=0.04) and
8000 HZ (right ear: p=0.04; left ear: p=0.03) when compared with
baseline values. Audiograms did not show significant changes in the
active group at 2000, 4000, and 8000 Hz. Evoked brainstem responses
remained unchanged in both groups. The planned follow-up evaluations
weren’t completed because of a 37% patient drop-out (Villani et al.,
2016). Ultimately a case-control study tested if dietary supplementation
with coenzyme Q10 plus multivitamins could preemptively reduce reactive
oxygen species and consequently CiO. They found that patients on dietary
supplementation, 7 days before and 21 days after chemotherapy, had a
significantly lower amount of reactive oxygen metabolite derivatives (P
< 0.05) and a stable range of blood antioxidants (P
< 0.05) compared to the control group. Moreover, the
intervention group showed lesser augmentation on the hearing threshold
level at 8000 Hz frequency 6.9 ± 11.8 dB compared to the control group
20.0 ± 16.2 dB (P < 0.05). Similarly, tinnitus incidence was
higher in the control group (62.5% vs 11.1% P < 0.05). In
this study, 69% of patients received concomitant head radiation (dose
not specified)(Scasso et al., 2017). None of the studies reported
adverse effects due to vitamin supplementation, only the patient´s
dislikeness for the taste of the supplementation product.