The Efficacy and Safety of Nutritional Supplements for Cancer Supportive Care: An Umbrella Review and Hierarchical Evidence Synthesis.
Level 1 - systematic review of randomized trials
Umbrella review and evidence synthesis of systematic reviews of randomized controlled trials
PubMed 41482855 · doi:10.1177/15347354251405267
What was done
Authors conducted an umbrella review across five databases searching for systematic reviews and meta-analyses on nutritional supplements for supportive cancer care, excluding indications of pain, anxiety, and depression. Review quality was appraised using AMSTAR 2. The search identified 52 reviews reporting on 250 randomized controlled trials evaluating 18 nutritional supplements across 16 indications.
What was found
Almost all included reviews were rated as low or critically low quality on AMSTAR 2. Moderate-certainty evidence was found for amino acids and oral proteolytic enzymes reducing the severity of radiation-induced dermatitis, and N-acetyl cysteine preventing chemotherapy-induced peripheral neuropathy (CIPN) in individuals with gastrointestinal cancers. Low to very low certainty evidence suggested possible benefits for glutamine, zinc, probiotics, and melatonin in oral mucositis, and vitamin E, omega-3 fatty acids, glutamine, and other amino acids for CIPN prevention. Serious adverse events occurred with high-dose vitamin A, and dose-related adverse events occurred with zinc and vitamin E. The abstract reports no numerical effect sizes.
Why it matters
This synthesis provides a comprehensive map of nutritional supplement evidence in oncology, demonstrating that most common uses still lack sufficiently high-certainty data to support firm clinical recommendations.
Limits
Almost all included systematic reviews had low or critically low methodological quality. The review excluded pain, anxiety, and depression, and did not measure or evaluate the direct impact of supplements on the efficacy of standard antineoplastic treatments.
Cited by
- supports Glutamine supplementation is used in oncology to help patients recover from and combat the side effects of chemotherapy.