Department of Medical and Surgical Science, University Magna Grecia, 88100 Catanzaro, Italy.
Department of Clinical and Experimental Medicine, University Magna Grecia, 88100 Catanzaro, Italy.
Nutrients. 2023 Jun 8;15(12):2666. doi: 10.3390/nu15122666.
The aim of this study was to assess the available evidence regarding the effect of a variety of fasting-like regimens on preventing chemotherapy-related side effects. PubMed, Scopus and Embase were used to select the studies for this review, which concluded on 24 November 2022. All types of clinical trials and case series reporting chemotherapy toxicity associated with fasting regimens and any comparison were considered. A total of 283 records were identified, of which 274 were excluded, leaving only nine studies that met the inclusion criteria. Five of these trials were randomized. Overall, moderate to high-quality evidence showed that several fasting regimens did not provide benefits compared to a conventional diet or other comparators in reducing the risk of adverse events. The overall pooled estimate for a variety of fasting regime when compared to non-fasting, indicated no significant difference in the side effects (RR = 1.10; 95% CI: 0.77-1.59; = 10%, = 0.60), including neutropenia alone (RR = 1.33; 95% CI: 0.90-1.97; = 0%, = 0.15). A sensitivity analysis confirmed these results. Based on our systematic review and meta-analysis, there is currently no evidence supporting the superiority of therapeutic fasting over non-fasting in preventing chemotherapy toxicity. The development of cancer treatment that do not entail toxicities remains imperative.
本研究旨在评估各种类似禁食方案预防化疗相关副作用的效果的现有证据。使用 PubMed、Scopus 和 Embase 选择本综述的研究，研究截止日期为 2022 年 11 月 24 日。所有报告与禁食方案相关的化疗毒性的临床试验类型和病例系列以及任何比较均被考虑在内。共确定了 283 条记录，其中 274 条被排除，仅留下符合纳入标准的 9 项研究。其中 5 项试验为随机对照试验。总体而言，高质量证据表明，与常规饮食或其他对照相比，几种禁食方案在降低不良事件风险方面没有益处。与非禁食相比，各种禁食方案的总体汇总估计表明，在副作用方面没有显著差异（RR = 1.10；95%CI：0.77-1.59； = 10%， = 0.60），包括中性粒细胞减少症单独发生时（RR = 1.33；95%CI：0.90-1.97； = 0%， = 0.15）。敏感性分析证实了这些结果。基于我们的系统评价和荟萃分析，目前没有证据支持治疗性禁食在预防化疗毒性方面优于非禁食。开发不伴有毒性的癌症治疗方法仍然至关重要。
