Scafuri Luca, Buonerba Carlo, Strianese Oriana, de Azambuja Evandro, Palleschi Michela, Riccio Vittorio, Marotta Vincenzo, Scocca Concetta, Riccio Giovanni, Errico Carla, Arpino Grazia, Di Lorenzo Giuseppe
Oncology Unit, "Andrea Tortora" Hospital, ASL Salerno, 84016 Pagani, Italy.
Associazione O.R.A. ETS-Oncology Research Assistance, 84134 Salerno, Italy.
Nutrients. 2025 Mar 11;17(6):981. doi: 10.3390/nu17060981.
This systematic review aimed to evaluate the efficacy and safety of dietary supplements in breast cancer patients, focusing on their impact on clinical outcomes, treatment-related side effects, and therapy adherence. Only RCTs investigating the effects of various orally administered supplements in adult breast cancer patients were included. Well-defined substances like vitamins, minerals, antioxidants, and specific herbal extracts were explored. The review excluded studies solely based on dietary interventions or non-supplemental approaches. The primary outcome assessed was quality of life. Secondary outcomes included disease-free survival, overall survival, tumor response, and biomarkers indicative of disease progression. A total of 45 randomized controlled trials (RCTs) were included in this systematic review. Overall, supplementation was not associated with serious adverse events in the included trials. Vitamin D supplementation showed promise in some studies, with potential immunomodulatory and antioxidant effects, particularly when combined with other interventions. Omega-3 fatty acids and beta-glucan demonstrated potential in alleviating certain symptoms and improving quality of life. Studies on amino acids like acetyl-L-carnitine and L-arginine also yielded mixed results. Beta-glucan exhibited potential for immune-enhancing effects, while melatonin and creatine showed limited or no benefit for fatigue or muscle strength. Herbal extracts, including silymarin, curcumin, and EGCG, had varied effects. Curcumin studies presented mixed results. Silymarin showed potential for hepatoprotective effects. These findings highlight the potential of specific dietary supplements to improve various aspects of breast cancer care. However, the evidence is mixed across supplement types, and further research is needed to determine the most effective and safe approaches.
本系统评价旨在评估膳食补充剂对乳腺癌患者的疗效和安全性,重点关注其对临床结局、治疗相关副作用和治疗依从性的影响。仅纳入了调查各种口服补充剂对成年乳腺癌患者影响的随机对照试验(RCT)。研究了维生素、矿物质、抗氧化剂和特定草药提取物等明确的物质。该评价排除了仅基于饮食干预或非补充方法的研究。评估的主要结局是生活质量。次要结局包括无病生存期、总生存期、肿瘤反应以及指示疾病进展的生物标志物。本系统评价共纳入了45项随机对照试验(RCT)。总体而言,在所纳入的试验中,补充剂与严重不良事件无关。在一些研究中,补充维生素D显示出前景,具有潜在的免疫调节和抗氧化作用,尤其是与其他干预措施联合使用时。ω-3脂肪酸和β-葡聚糖在缓解某些症状和改善生活质量方面显示出潜力。关于乙酰-L-肉碱和L-精氨酸等氨基酸的研究结果也参差不齐。β-葡聚糖具有免疫增强作用的潜力,而褪黑素和肌酸对疲劳或肌肉力量的益处有限或没有益处。草药提取物,包括水飞蓟素、姜黄素和表没食子儿茶素没食子酸酯(EGCG),具有不同的作用。姜黄素的研究结果不一。水飞蓟素显示出肝脏保护作用的潜力。这些发现突出了特定膳食补充剂在改善乳腺癌护理各个方面的潜力。然而,不同类型补充剂的证据参差不齐,需要进一步研究以确定最有效和安全的方法。