Abstract
(1) Background: Cancer is one of the leading causes of mortality worldwide. Radiotherapy and chemotherapy attempt to kill tumor cells by different mechanisms mediated by an intracellular increase of free radicals. However, free radicals can also increase in healthy cells and lead to oxidative stress, resulting in further damage to healthy tissues. Approaches to prevent or treat many of these side effects are limited. Ozone therapy can induce a controlled oxidative stress able to stimulate an adaptive antioxidant response in healthy tissue. This review describes the studies using ozone therapy to prevent and/or treat chemotherapy-induced toxicity, and how its effect is linked to a modification of free radicals and antioxidants. (2) Methods: This review encompasses a total of 13 peer-reviewed original articles (most of them with assessment of oxidative stress parameters) and some related works. It is mainly focused on four drugs: Cisplatin, Methotrexate, Doxorubicin, and Bleomycin. (3) Results: In experimental models and the few existing clinical studies, modulation of free radicals and antioxidants by ozone therapy was associated with decreased chemotherapy-induced toxicity. (4) Conclusions: The potential role of ozone therapy in the management of chemotherapy-induced toxicity merits further research. Randomized controlled trials are ongoing.
Highlights
Chemotherapy (CT) is one of the main treatments for cancer
Compared with patients treated in the MTX group, at the end of the study, patients treated with concurrent ozone therapy showed significantly higher levels of antioxidants (SOD, CAT, GSH) and lower levels of oxidative stress markers such asmarkers advanced oxidation proteinoxidation products protein (AOPP),products nitric oxide (NO),nitric total lower levels of oxidative stress such as advanced (AOPP), hydroperoxides (TH)
The results described with ozone in the experimental models detailed in this review augur well for a potential clinical benefit, and they are further supported by increased survival in the experimental model of doxorubicin plus ozone [57] or the results in the clinical trial of patients with arthritis treated with methotrexate with/without ozone therapy [56]
Summary
In experimental models and the few existing clinical studies, modulation of free radicals and antioxidants by ozone therapy was associated with decreased chemotherapy-induced toxicity. (4) Conclusions: The potential role of ozone therapy in the management of chemotherapy-induced toxicity merits further research.
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