Träsel Henrique de Araújo Vianna, Falcetta Frederico Soares, de Almeida Fernando Kude, Falcetta Mariana Rangel Ribeiro, Ribeiro Rodrigo Antonini, Rosa Daniela Dornelles
Post-Graduate Program of Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.
Universidade do Vale do Rio dos Sinos, UNISINOS, São Leopoldo, Brazil.
Breast Care (Basel). 2021 Dec;16(6):648-656. doi: 10.1159/000514469. Epub 2021 Feb 25.
Randomized clinical trials (RCT) are inconclusive regarding the role of dietary interventions in anthropometric measurements and survival in breast cancer patients. Our aim was to conduct a systematic review and meta-analysis to assess the effects of diet on these outcomes in women treated for early-stage breast cancer.
Embase, MEDLINE, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials were searched for RCT comparing dietary interventions (individualized dietary counseling, prescription of a specific diet, or others) with usual care in women that were treated for early breast cancer. Primary outcomes were overall survival (OS) and disease-free survival (DFS); secondary outcome was a change in body mass index (BMI).
We found 12 RCT eligible for analysis, 7 of which were included in the quantitative analysis. Two studies reported OS and DFS and 6 reported BMI data. The hazard ratio (HR) for OS and DFS was 0.91 (95% confidence interval [CI] 0.77-1.07, = 0.25) and 0.92 (95% CI 0.79-1.08, = 0.31) for the intervention and control groups, respectively. Intervention was associated with BMI reduction in subjects who received a specific diet instead of counseling or other types of intervention (-0.67; 95% CI -1.14 to -0.21).
Despite increasing survival among breast cancer patients due to better oncological treatments, there is still a lack of prospective data regarding the effects of dietary interventions in this population. We found positive association between prescription of specific diets in terms of anthropometric measures; there were no differences in OS or DFS.
关于饮食干预在乳腺癌患者人体测量指标及生存方面的作用,随机临床试验(RCT)尚无定论。我们的目的是进行一项系统评价和荟萃分析,以评估饮食对早期乳腺癌女性患者这些结局的影响。
在Embase、MEDLINE、Cochrane系统评价数据库和Cochrane对照试验中心注册库中检索RCT,比较饮食干预(个体化饮食咨询、特定饮食处方或其他)与早期乳腺癌女性常规护理的效果。主要结局为总生存期(OS)和无病生存期(DFS);次要结局为体重指数(BMI)的变化。
我们发现12项RCT符合分析条件,其中7项纳入定量分析。两项研究报告了OS和DFS,6项报告了BMI数据。干预组和对照组的OS和DFS风险比(HR)分别为0.91(95%置信区间[CI]0.77 - 1.07,P = 0.25)和0.92(95%CI 0.79 - 1.08,P = 0.31)。接受特定饮食而非咨询或其他类型干预的受试者中,干预与BMI降低相关(-0.67;95%CI -1.14至-0.21)。
尽管由于更好的肿瘤治疗方法,乳腺癌患者的生存率有所提高,但关于饮食干预对该人群影响的前瞻性数据仍然缺乏。我们发现特定饮食处方在人体测量指标方面存在正相关;OS或DFS无差异。