One hundred and fifty patients with advanced cancer participated in a controlled double-blind study to evaluate the effects of high-dose vitamin C on symptoms and survival. Patients were divided randomly into a group that received vitamin C (10 g per day) and one that received a comparably flavored lactose placebo. Sixty evaluable patients received vitamin C and 63 received a placebo. Both groups were similar in age, sex, site of primary tumor, performance score, tumor grade and previous chemotherapy. The two groups showed no appreciable difference in changes in symptoms, performance status, appetite or weight. The median survival for all patients was about seven weeks, and the survival curves essentially overlapped. In this selected group of patients, we were unable to show a therapeutic benefit of high-dose vitamin C treatment. (N Engl J Med 301:687–690, 1979) THE possible role of vitamin C in both the pathogenesis and therapy of malignant disease has been suggested by a variety of laboratory and clinical data. A deficiency of ascorbate has been reported in association with dissolution of the intercellular matrix, which might facilitate local infiltration and dissemination of neoplastic cells.1 Studies in laboratory animals have shown that ascorbate seems to concentrate in malignant tissue and thus depletes systemic reserves.2 3 4 Moreover, in patients with skin carcinoma, concentrations of vitamin C are higher in the tumor than in surrounding normal tissue.5 Lymphocytes, mediators of cellular immunity, contain relatively high amounts of. © 1979, Massachusetts Medical Society. All rights reserved.
