Trial reportJournal of clinical oncology : official journal of the American Society of Clinical Oncology2020
Dietary Supplement Use During Chemotherapy and Survival Outcomes of Patients With Breast Cancer Enrolled in a Cooperative Group Clinical Trial (SWOG S0221).
Trial report in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 141 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
141 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Impact of Nutritional Supplements and Antioxidants in the Treatment of Breast Cancer: A Systematic Review.Nutrients · 2026Pooled it
- The influence of antioxidant supplementation on adverse effects and tumor interaction during radiotherapy: a systematic review.Clinical and experimental medicine · 2025Pooled it
- Nutritional Counseling During Chemotherapy Treatment: A Systematic Review of Feasibility, Safety, and Efficacy.Current oncology (Toronto, Ont.) · 2024Pooled it
- Postdiagnosis dietary factors, supplement use and breast cancer prognosis: Global Cancer Update Programme (CUP Global) systematic literature review and meta-analysis.International journal of cancer · 2023Pooled it
- Post-Diagnosis Vitamin D Supplement Use and Survival among Cancer Patients: A Meta-Analysis.Nutrients · 2022Pooled it
- Addressing Complementary and Alternative Medicine Use Among Individuals With Cancer: An Integrative Review and Clinical Practice Guideline.Journal of the National Cancer Institute · 2022Guideline
- Systemic therapies for preventing or treating aromatase inhibitor-induced musculoskeletal symptoms in early breast cancer.The Cochrane database of systematic reviews · 2022Pooled it
- Effect of methylcobalamin on capecitabine induced hand-foot syndrome in patients with HER2 negative early breast cancer: multicentre, double blind, randomised, placebo controlled, phase 3 trial.BMJ (Clinical research ed.) · 2025Trial
- Pre-treatment amino acids and risk of paclitaxel-induced peripheral neuropathy in SWOG S0221.Cancer chemotherapy and pharmacology · 2024Trial
- Dietary supplement intake in women with breast cancer before and after diagnosis: results from the SUCCESS C trial.BMC cancer · 2024Trial
- Circulating Vitamin D Levels and DNA Repair Capacity in Four Molecular Subtypes of Women with Breast Cancer.International journal of molecular sciences · 2020Trial
- Phase I Randomized, Placebo-Controlled, Cross-Over Dose-Finding Study of Coenzyme Q10 on Doxorubicin Pharmacokinetics during Breast Cancer Treatment.Integrative cancer therapiesTrial
- Dietary supplement use throughout the colorectal cancer disease trajectory: a prospective cohort study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Targeting the tumor microenvironment: a new strategy for natural products in breast cancer therapy.Natural products and bioprospecting · 2026Review
- Use of dietary supplements and over-the-counter products among adults with a self-reported history of cancer in Poland.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Targeting Reactive Species Stress and Nutrient Sensing to Enhance NK-Cell Function: Mechanistic Strategies for Overcoming Pancreatic Cancer Progression and Resistance Through Supplement Therapy.International journal of molecular sciences · 2026Review
- Nutritional Prevention of Oxidative Stress-Induced Cardiotoxicity in Pediatric Cardio-Oncology: Molecular Mechanisms and Translational Perspectives-A Narrative Review.International journal of molecular sciences · 2026Review
- Reactive Oxygen Species in Breast Cancer: From Redox Dysregulation to ROS-Responsive Therapeutics.Cell biochemistry and function · 2026Review
- Patterns and perceptions of supplement use among patients with plasma cell disorders.Blood cancer journal · 2026Article
- Nutrition as Modulator of Oxidative Stress in Cancer Prevention and Treatment.International journal of molecular sciences · 2026Review
81 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
20 authors.
Funding
Abstract
purposeDespite reported widespread use of dietary supplements during cancer treatment, few empirical data with regard to their safety or efficacy exist. Because of concerns that some supplements, particularly antioxidants, could reduce the cytotoxicity of chemotherapy, we conducted a prospective study ancillary to a therapeutic trial to evaluate associations between supplement use and breast cancer outcomes.
methodsPatients with breast cancer randomly assigned to an intergroup metronomic trial of cyclophosphamide, doxorubicin, and paclitaxel were queried on their use of supplements at registration and during treatment (n =1,134). Cox proportional hazards regression adjusting for clinical and lifestyle variables was used. Recurrence and survival were indexed at 6 months after enrollment using a landmark approach.
resultsThere were indications that use of any antioxidant supplement (vitamins A, C, and E; carotenoids; coenzyme Q10) both before and during treatment was associated with an increased hazard of recurrence (adjusted hazard ratio [adjHR], 1.41; 95% CI, 0.98 to 2.04;
conclusionAssociations between survival outcomes and use of antioxidant and other dietary supplements both before and during chemotherapy are consistent with recommendations for caution among patients when considering the use of supplements, other than a multivitamin, during chemotherapy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.