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维生素和膳食补充剂在癌症治疗中的应用:是否需要增加其使用量?

Vitamins and dietary supplements in cancer treatment: is there a need for increased usage?

作者信息

Esposito Teresa, Pentimalli Francesca, Giordano Antonio, Cortellino Salvatore

机构信息

Department of Clinical Dietetics and Metabolic Diseases, Cavalier Raffaele Apicella Hospital, ASL Napoli 3 Sud, Naples, Italy.

Department of Medicine and Surgery, LUM University "Giuseppe De Gennaro", Bari, Italy.

出版信息

Expert Rev Anticancer Ther. 2025 Jun;25(6):687-710. doi: 10.1080/14737140.2025.2501077. Epub 2025 May 7.

Abstract

INTRODUCTION

Vitamins are essential for homeostasis and proper functioning of organisms. These micronutrients prevent tumor onset by functioning as antioxidants and enzymatic cofactors involved in anti-stress and immune responses, modulating epigenetic regulators, and shaping the microbiota composition. Unbalanced diets and sedentary lifestyles contribute to obesity, associated with increasing cancer risk. Cancer patients often exhibit vitamin deficiencies due to chronic inflammation, anticancer therapies, and tumor-induced metabolic changes, leading to malnutrition and cachexia.

AREAS COVERED

This review critically analyzes preclinical and clinical studies, sourced from PubMed and ClinicalTrials.gov databases, that investigate the potential benefits of vitamin supplementation and dietary interventions, such as intermittent fasting and ketogenic diets, in mouse tumor models and cancer patients. This analysis elucidates the limitations of such interventions and suggests optimal dietary strategies to prevent cancer and enhance patients' quality of life and prognosis.

EXPERT OPINION

To date, clinical studies have found no substantial benefit of over-the-counter vitamin supplements and dietary interventions on cancer patients' health and prognosis. To prevent the spread of useless and potentially harmful products by the nutraceutical industry, establishing a regulatory authority is necessary to monitor and ensure product quality and validity before commercialization.

摘要

引言

维生素对于生物体的内环境稳定和正常功能至关重要。这些微量营养素通过作为抗氧化剂和参与抗应激及免疫反应的酶辅因子发挥作用、调节表观遗传调节因子以及塑造微生物群组成来预防肿瘤发生。不均衡的饮食和久坐不动的生活方式会导致肥胖,而肥胖与癌症风险增加相关。癌症患者常因慢性炎症、抗癌治疗和肿瘤诱导的代谢变化而出现维生素缺乏,进而导致营养不良和恶病质。

涵盖领域

本综述批判性地分析了来自PubMed和ClinicalTrials.gov数据库的临床前和临床研究,这些研究调查了在小鼠肿瘤模型和癌症患者中补充维生素及进行饮食干预(如间歇性禁食和生酮饮食)的潜在益处。该分析阐明了此类干预措施的局限性,并提出了预防癌症以及提高患者生活质量和预后的最佳饮食策略。

专家意见

迄今为止,临床研究尚未发现非处方维生素补充剂和饮食干预对癌症患者的健康和预后有实质性益处。为防止营养保健品行业传播无用且可能有害的产品,有必要设立一个监管机构,在产品商业化之前监测并确保其质量和有效性。

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