TNF and female reproductive organ cancer: In another study, Maccio et al found that in patients with advanced gynecological cancer combination of L-carnitine+celecoxib+antioxidants (alpha lipoic acid and carboxycysteine)+Megestrol acetat (MA) was more effective than MA (alone) in improving global quality of life patients.20 Another results of their study were that inflammatory factors (IL-6, TNF-α, CRP) reduced significantly in the combination treatment group while these variables did not change in the MA group.