Skin toxicity following radiotherapy in patients with breast carcinoma: is anthocyanin supplementation beneficial?. Issue 4 (April 2021)

• Record Type: Journal Article
• Authors: Bracone, Francesca; De Curtis, Amalia; Di Castelnuovo, Augusto; Pilu, Roberto; Boccardi, Mariangela; Cilla, Savino; Macchia, Gabriella; Deodato, Francesco; Costanzo, Simona; Iacoviello, Licia; de Gaetano, Giovanni; Morganti, Alessio Giuseppe; Petroni, Katia; Tonelli, Chiara; Donati, Maria Benedetta; Cerletti, Chiara
• Is Part Of: Clinical nutrition. Volume 40:Issue 4(2021)
• Page Start: 2068
• Page End: 2077
• Publication Date: 2021-04
• Subjects: Anthocyanin -- Radiotherapy -- Skin toxicity -- Cutometer-mexameter -- Inflammation -- Lipids; Critically ill -- Nutrition -- Periodicals; Diet therapy -- Periodicals; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; Enteral Nutrition -- Periodicals; Parenteral Nutrition -- Periodicals; Metabolism -- Periodicals; Diétothérapie -- Périodiques; Alimentation parentérale -- Périodiques; Alimentation entérale -- Périodiques; Nutrition -- Périodiques; Diet therapy; Enteral feeding; Nutrition; Parenteral feeding; Electronic journals; Periodicals; Electronic journals; 615.854
• DOI: 10.1016/j.clnu.2020.09.030
• Languages: English
• ISSNs: 0261-5614

Abstract

Summary: Background: The EU-supported ATHENA project stems from a previous study suggesting that moderate wine consumption reduced the side-effects of radiotherapy (RT) in breast cancer patients, an effect possibly due to non-alcoholic anthocyanin fractions of wine. Objective: To evaluate the role of anthocyanins on RT skin side effects in breast cancer patients. Methods: Randomized, controlled, double-blind clinical trial. Patients were assigned to an intensity modulated radiation therapy (IMRT) either for three or five weeks, then randomized to receive three times a day a water-soluble anthocyanin (125 mg)-rich extract of corn cob or a placebo. Supplementation started one week before till the end of RT. Skin characteristics were detected by a standardized, non-invasive Cutometer® dual-MPA580, providing quantitative indices of skin maximal distensibility (R0), elasticity (R2, R5, R7) and viscoelasticity (R6); a Mexameter® MX18 probe evaluated the skin erythema (Er) and melanin (M). Measures were performed before (T0), at the end of RT and of supplementation (T1), and 1, 6 and 12 months after RT (T2-T4). Acute and late skin toxicity were scored according to the RTOG/EORTG scale. Selected biomarkers were measured at T0 and T1. Results: 193 patients previously assigned to 3- or 5-week RT schedules were randomized to either anthocyanin (97) or placebo (96) supplementation. RT induced changes in skin parameters: R0, R2, R5 and R7 decreased, while R6 increased; the changes in R0 and R6 continued in the same direction up to one year, while the others recovered towards basal values; Er and M peaked at T1 and T2, respectively, and returned to basal values at T4. Comparable skin changes were apparent in anthocyanin and placebo groups. A moderate RT-induced increase in total and HDL cholesterol and triglycerides was prevented by anthocyanins. Conclusions: Anthocyanin supplementation did not prevent RT-induced local skin toxicity. The supplementation was well tolerated and safe.