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药用蘑菇补充剂在癌症中的应用:临床研究的系统评价。

Medicinal Mushroom Supplements in Cancer: A Systematic Review of Clinical Studies.

机构信息

Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Department of Biotechnology, Institute of Graduate Studies and Research (IGSR), Alexandria University, Alexandria, Egypt.

出版信息

Curr Oncol Rep. 2023 Jun;25(6):569-587. doi: 10.1007/s11912-023-01408-2. Epub 2023 Mar 30.

Abstract

PURPOSE OF REVIEW

Patients seek clinical guidance on mushroom supplements that can be given alongside conventional treatments, but most research on such fungi has been preclinical. The current systematic review focused on clinical studies of mushrooms in cancer care conducted in the past 10 years. We searched Medline (Ovid), Embase (Ovid), Scopus (Wiley), and Cochrane Library to identify all mushroom studies conducted in humans published from January 2010 through December 2020. Two authors independently assessed papers for inclusion.

RECENT FINDINGS

Of 136 clinical studies identified by screening 2349, 39 met inclusion criteria. The studies included 12 different mushroom preparations. A survival benefit was reported using Huaier granules (Trametes robiniophila Murr) in 2 hepatocellular carcinoma studies and 1 breast cancer study. A survival benefit was also found in 4 gastric cancer studies using polysaccharide-K (polysaccharide-Kureha; PSK) in the adjuvant setting. Eleven studies reported a positive immunological response. Quality-of-life (QoL) improvement and/or reduced symptom burden was reported in 14 studies using various mushroom supplements. Most studies reported adverse effects of grade 2 or lower, mainly nausea, vomiting, diarrhea, and muscle pain. Limitations included small sample size and not using randomized controlled trial design. Many of the reviewed studies were small and observational. Most showed favorable effects of mushroom supplements in reducing the toxicity of chemotherapy, improving QoL, favorable cytokine response, and possibly better clinical outcomes. Nevertheless, the evidence is inconclusive to recommend the routine use of mushrooms for cancer patients. More trials are needed to explore mushroom use during and after cancer treatment.

摘要

目的综述:患者希望获得关于可与常规治疗一起使用的蘑菇补充剂的临床指导,但大多数此类真菌的研究都是临床前的。本次系统综述重点关注过去 10 年中在癌症治疗中进行的蘑菇的临床研究。我们检索了 Medline(Ovid)、Embase(Ovid)、Scopus(Wiley)和 Cochrane Library,以确定从 2010 年 1 月至 2020 年 12 月期间在人类中进行的所有蘑菇研究。两位作者独立评估了纳入论文的标准。

最新发现:通过筛选 2349 篇文章,共确定了 136 项临床研究,其中 39 项符合纳入标准。这些研究包括 12 种不同的蘑菇制剂。两项肝细胞癌研究和一项乳腺癌研究报告了使用 Huaier 颗粒(云芝)的生存获益,四项胃癌研究报告了使用多糖 K(多糖 Cureha;PSK)在辅助治疗中的生存获益。11 项研究报告了阳性免疫反应。使用各种蘑菇补充剂的 14 项研究报告了生活质量(QoL)的改善和/或症状负担的减轻。大多数研究报告的不良反应为 2 级或更低,主要为恶心、呕吐、腹泻和肌肉疼痛。研究存在局限性,包括样本量小,未采用随机对照试验设计。许多综述研究规模较小且为观察性研究。大多数研究表明,蘑菇补充剂在减轻化疗毒性、改善 QoL、有利的细胞因子反应和可能更好的临床结果方面具有有利影响。然而,目前的证据尚不足以推荐常规使用蘑菇来治疗癌症患者。需要更多的试验来探索蘑菇在癌症治疗期间和之后的使用。

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