The effect of probiotics supplementation on cancer-treatment complications: a critical umbrella review of interventional meta-analyses

Abstract

Cancer-related complications pose significant challenges in the management and treatment of patients with malignancies. Several meta-analyses have indicated improving effects of probiotics on cancer complications, while some studies have reported contentious findings. The purpose of the present study was to evaluate the efficacy of probiotics in addressing cancer complications, including diarrhea, mucositis, and infections, following chemotherapy, radiotherapy, and surgery. Relevant studies were searched in the PubMed, Scopus, Embase and Web of Science databases and Google Scholar up to September 2023. All meta-analyses addressing the effects of probiotics on all cancer treatments-induced complications including infection, diarrhea and oral mucositis were included. The pooled results were calculated using a random-effects model. Analyses of subgroups, sensitivity and publication bias were also conducted. The results revealed that the probiotics supplementation was effective on reduction of total cancer complications (OR:0.53; 95% CI: 0.44, 0.62, p < 0.001; I²=79.0%, p < 0.001), total infection rate (OR:0.47; 95%CI: 0.41, 0.52, p < 0.001; I²= 48.8%, p < 0.001); diarrhea (OR:0.50; 95%CI: 0.44, 0.57, p < 0.001; I²=44.4%, p = 0.023) and severe diarrhea (OR: 0.4; 95%CI: 0.27, 0.56, p < 0.001; I²=31.3%, p = 0.178), oral mucositis (OR: 0.76; 95%CI: 0.58, 0.94, p < 0.001; I²=95.5%, p < 0.001) and severe oral mucositis (OR:0.65, 95%CI: 0.58, 0.72 p < 0.001; I²=22.1%, p = 0.274). Multi strain probiotic (OR:0.49; 95%CI: 0.32, 0.65, p < 0.001; I²=90.7%, p < 0.001) were more efficacious than single strain (OR:0.73; 95%CI: 0.66, 0.81, p < 0.001; I²=0.00%, p = 0.786). The findings of the current umbrella meta-analysis provide strong evidence that probiotic supplementation can reduce cancer complications.

Keywords:

• Probiotics
• cancer
• umbrella meta-analysis

Acknowledgement

The research protocol was approved and Supported by Student Research Committee, Tabriz University of Medical Sciences (Registration code: 73006).

Availability of data

Data will be made available upon reasonable request.

Authors’ contribution

ZY: Drafting of the manuscript, Study concept and design, Final approval; SZ: Drafting of the manuscript, Interpretation of data, Final approval; LY: Acquisition of data, Drafting of the manuscript, Final approval; WZ: Acquisition of data, Interpretation of data, Final approval; XC: Acquisition of data, Interpretation of data, Final approval; YL: Acquisition of data, Final approval; RC: Acquisition of data, Final approval; KY: Acquisition of data, Final approval; CL: Acquisition of data, Final approval; CY: Acquisition of data, Final approval; PJ: Acquisition of data, critical revision of the manuscript for important intellectual content, Final approval; MZ: Contribution to data analysis, critical revision of the manuscript for important intellectual content, Final approval; HKV: Critical revision of the manuscript for important intellectual content, Final approval; HL: Study concept and design, critical revision of the manuscript for important intellectual content, study supervision, Final approval; JW: Study concept and design, critical revision of the manuscript for important intellectual content, study supervision, Final approval

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Disclosure statement

None.

Additional information

Funding

Major Research Plan of the National Natural Science Foundation of China (92359202), National Natural Science Foundation of China (81973669, 81603484, 81703912), National Key Clinical Specialty Construction Project (2020-QT L-009), Joint Project of Biomedical Translational Engineering Research Center of Beijing University of Chemical Technology-China-Japan Friendship Hospital (XK2023-21), Guangxi Administration of Traditional Chinese Medicine, Multidisciplinary Cross Innovation Team Project for Severe Liver Diseases (GZKJ2306), China Postdoctoral Science Foundation (2023M743141), Zhejiang Provincial Postdoctoral Research Project (ZJ2023009), the Scientific and Technological Research Project of Xinjiang Production and Construction Corps (2022AB022) and Li Hanmin Famous Old Traditional Chinese Medicine Inheritance Studio project.