Effect of Silymarin against CAF protocol Hepatotoxicity

Abstract

Breast cancer became the commonest type of cancers among Iraqi women since the last two decades. The main underlying cause is thought to be DNA
damage; much of which is oxidative in nature. CAF protocol (Cyclophosphamide + Adriamycin + 5-FU) associated with toxic effects in several body organs (like
liver), mainly through production of free radicals and reactive oxygen species. Silymarin, the dried extract of a ripe seeds of the plant silybium marianum, was
found to be a powerful antioxidant agent against toxin -induced tissue damage. Aim of the study is to evaluate the possible time and dose-dependent protective effect of the orally administered silymarin as antioxidant agent against oxidative stress-related hepatotoxicity induced by CAF protocol in breast cancer wome.
Seventy four breast cancer women randomly distributed and allocated into three groups:
Group (A): 24 patients received CAF protocol by I.V infusion once every 21 days and for 63 days.
Group (B): 25 patients received 210mg/day of silymarin along with the same CAF protocol of group (A).
Group (C): 25 patients received 420mg/day of silymarin along with the same CAF protocol of group (A).
Indices of liver function (AST, ALT,TSB) were measured at baseline, after 21, 42, and 63 days of treatment.

The levels of AST and ALT, which were significantly elevated due to CAF protocol therapy, showed significant reduction when silymarin used with CAF
protocol, in a time and dose-dependent manner. Mean while, TSB levels significantly reduced by CAF protocol but dose not show any significant change
after treatment with silymarin.
Use of antioxidant agent (silymarin) in this study can ameliorate, in a time and dose-dependant manner, liver damage that induced by oxidative stress.
Keywords: Breast cancer, CAF protocol (cyclophosphamide+Adriamycin+5- fluorouracil), hepatotoxicity, silymarin.