Раковая наука и терапия

The Role of Melatonin in Improving Clinical Responses of Chemotherapy in Solid Cancer Patients: A Systematic Review

Abstract

Diani Kartini, Sonar Soni Panigoro, Muchlis Ramli, Rianto Setiabudy and Akmal Taher

Background: Melatonin is known as a potent antioxidant. It also has other roles in modulating immune system and inhibiting proliferation, depending on the dose given. This agent has been used widely as a supplementation in cancer patients. However, effect of this antioxidant towards the efficacy of various therapeutic modalities in cancer, including chemotherapy, remains unclear.

Objective: This systematic review aims to know effect of melatonin as an adjuvant therapy towards chemotherapy response in solid cancer patients.

Methods: We reviewed articles systematically from 8 databases including Pubmed, EBSCO, Cochrane, ClinicalKey, Proquest, ScienceDirect, Scopus, and Wiley Online Library. Keywords used in literature searching were cancer and all similar terms, melatonin, chemotherapy, and response. We used limitations to narrow the result. We included clinical trials that evaluated clinical response of chemotherapy in solid cancer patients. Studies were reviewed by two authors using OXFORD RCT appraisal sheets.

Results: The results showed improved clinical response associated with chemotherapy plus melatonin treatment. Two out of eight studies were not statistically significant (p>0.05). There was high risk of bias in all of the studies regarding randomization process, allocation concealment, intention-to-treat principal, and blinding.

Conclusion: Melatonin has positive effect in improving chemotherapy response in solid cancer patients. Regarding the lack of methodological validation in prior studies, larger and well-designed studies are needed in the future.