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维生素 D 补充与癌症死亡率:观察性研究和临床试验的叙述性综述。

Vitamin D Supplementation and Cancer Mortality: Narrative Review of Observational Studies and Clinical Trials.

机构信息

Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy.

Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, 50139 Florence, Italy.

出版信息

Nutrients. 2021 Sep 21;13(9):3285. doi: 10.3390/nu13093285.

Abstract

Several studies have investigated the beneficial effects of vitamin D on survival of cancer patients. Overall evidence has been accumulating with contrasting results. This paper aims at narratively reviewing the existing articles examining the link between vitamin D supplementation and cancer mortality. We performed two distinct searches to identify observational (ObS) studies and randomized clinical trials (RCTs) of vitamin D supplementation (VDS) in cancer patients and cohorts of general population, which included cancer mortality as an outcome. Published reports were gathered until March 2021. We identified 25 papers published between 2003 and 2020, including n. 8 RCTs on cancer patients, n. 8 population RCTs and n. 9 ObS studies. There was some evidence that the use of VDS in cancer patients could improve cancer survival, but no significant effect was found in population RCTs. Some ObS studies reported evidence that VDS was associated with a longer survival among cancer patients, and only one study found an opposite effect. The findings do not allow conclusive answers. VDS may have the potential as treatment to improve survival in cancer patients, but further investigations are warranted. We strongly support investment in well-designed and sufficiently powered RCTs to fully evaluate this association.

摘要

多项研究探讨了维生素 D 对癌症患者生存的有益影响。总体证据不断积累,但结果却相互矛盾。本文旨在对现有评估维生素 D 补充与癌症死亡率之间关联的文章进行叙述性综述。我们进行了两次独立检索,以确定观察性研究(ObS)和癌症患者维生素 D 补充(VDS)的随机临床试验(RCT)以及一般人群队列,其中将癌症死亡率作为一个结果。检索到的报告截止到 2021 年 3 月。我们共确定了 25 篇发表于 2003 年至 2020 年的论文,其中包括 8 项针对癌症患者的 RCT、8 项人群 RCT 和 9 项 ObS 研究。有一些证据表明,癌症患者使用 VDS 可能会提高癌症生存率,但人群 RCT 中未发现显著效果。一些 ObS 研究报告的证据表明,VDS 与癌症患者的生存期延长有关,只有一项研究发现了相反的效果。这些发现无法得出明确的结论。VDS 可能具有作为治疗方法改善癌症患者生存的潜力,但需要进一步的研究。我们强烈支持投资于精心设计和充分有力的 RCT,以充分评估这种关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5363/8466115/ce787a5758c0/nutrients-13-03285-g001.jpg

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