Effects of Circulating 25(OH)D Status in Advanced Colorectal Cancer Patients Undergoing Chemotherapy: A Systematic Review

Anticancer Res. 2021 Dec;41(12):5903-5912. doi: 10.21873/anticanres.15409.

Abstract

Background/aim: Colorectal cancer (CRC) is a disease of poor prognosis. An advantageous connection between vitamin D supplementation and prognostic improvement was depicted in CRC patients. However, the effects of circulating vitamin D on cancer outcomes are unclear for advanced CRC patients, especially for those receiving chemotherapy.

Materials and methods: The review was registered on PROSPERO (register number: CRD42021243547). PUBMED, EMBASE, Cochrane Library, and Web of Science were searched for English-language publications using relevant keywords. Two reviewers independently selected articles, assessed quality, and extracted data. We applied RevMan5.4 and Stata14 for meta-analysis.

Results: We included an RCT and three prospective cohort studies, which were of high overall quality. Higher circulating 25(OH)D level was related with better disease outcomes in advanced CRC patients undergoing chemotherapy: progression-free survival (HR=0.85, 95% CI=0.71-0.99; I2=34.4%), overall survival (OR=0.56, 95% CI=0.38-0.82; I2=0%).

Conclusion: High circulating 25(OH)D content is beneficial for improving prognosis of advanced CRC receiving chemotherapy.

Keywords: 25-hydroxyvitamin D; Advanced colorectal cancer; chemotherapy; overall survival; progression-free survival; review.

Publication types

  • Systematic Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers / blood*
  • Colorectal Neoplasms / blood*
  • Colorectal Neoplasms / drug therapy
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / pathology
  • Humans
  • Neoplasm Metastasis
  • Neoplasm Staging
  • Odds Ratio
  • Prognosis
  • Publication Bias
  • Treatment Outcome
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood

Substances

  • Biomarkers
  • Vitamin D
  • 25-hydroxyvitamin D