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4.1 Risks of supplement use during chemotherapy The use of natural remedies during chemotherapy in breast cancer is a compound scenario that includes the safety issue as well as drugsupplement interferences and merits meticulous assessment, because these interventionsusually considered as harmless substancesmay significantly alter the pharmacokinetic/pharmacodynamic response, antitumoural activity, and toxicity profile to conventional oncologic treatment (200)

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Bauer, J

Synthesis Add 96g of acetic acid to the reaction vessel, add 32g of levulinic acid to dissolve under stirring, when completely dissolved, add 61.5g of acetic anhydride, then raise the temperature to 80 constant temperature reaction for 12 hours, the reaction is completed, in a vacuum of -0.09Mpa, the temperature of 80 below the distillation of acetic acid removal, reduce the temperature to 40 , add 160g of acetone, fully stirred and dispersed for 0.5 hours, reduced temperature to 5 below precipitation of crystals, and held between 0 ~ 5 for 2 hours, filtration and separation, wash the solid with acetone, in a vacuum -0.09 Mpa, dried at 80 , that is to obtain acetyl levulinic acid 36g finished product, yield 88.9%