DataSheet_1_The impact of pre-, pro- and synbiotics supplementation in colorectal cancer treatment: a systematic review.docx

IntroductionThe effectiveness of the supplementation of prebiotics, probiotics and synbiotics as a therapeutic approach in colorectal cancer (CRC) remains unclear. The aim of this systematic review is to critically examine the current scientific evidence on the impact of modulating the microbiota, through the use of prebiotics, probiotics and synbiotics, in patients diagnosed with CRC undergoing treatment, to determine the potential therapeutic use of this approach.MethodsThis systematic review was made according to the PRISMA 2020 guidelines. Inclusion criteria were randomized controlled trials (RCT) comparing the impact of pre-, pro-, or synbiotic supplementation with placebo or standard care in patients with CRC undergoing treatment. Exclusion criteria were non-human studies, non-RCTs, and studies in languages other than English or Portuguese. Six databases were consulted, namely, Cochrane Library, Pubmed, Scopus, Cinahl, MedicLatina and Web of Science until May of 2023. RAYYAN software was used to manage the search results and risk of bias was assessed according to the guidelines of the Cochrane Collaboration using the Rob 2.0 tool.ResultsTwenty-four RCTs met the inclusion criteria and were included in this review. Administration of pre-, pro-, or synbiotics improved surgical outcomes such as the incidence of infectious and non-infectious postoperative complications, return to normal gut function, hospital length of stay, and antibiotic usage. The supplementation of these microorganisms also alleviated some symptoms from chemotherapy and radiotherapy, mainly diarrhea. Evidence on the best approach in terms of types of strains, dosage and duration of intervention is still scarce.ConclusionsPre-, pro-, and synbiotics supplementation appears to be a beneficial therapeutic approach in CRC treatment to improve surgical outcomes and to alleviate side-effects such as treatment toxicity. More RCTs with larger sample sizes and less heterogeneity are needed to confirm these potential benefits and to determine the best strains, dosage, and duration of administration in each situation.Systematic review registrationhttps://www.crd.york.ac.uk/prospero, identifier CRD42023413958.

引言：对益生元、益生菌和合生元作为结直肠癌（CRC）治疗手段的补充效果，其有效性尚不明确。本系统综述旨在对现有科学证据进行批判性审查，以确定通过使用益生元、益生菌和合生元调节微生物群，对正在接受治疗的CRC患者的影响，从而确定该方法的潜在治疗应用。方法：本系统综述遵循PRISMA 2020指南。纳入标准为随机对照试验（RCT），比较正在接受治疗的CRC患者中，使用前、后或合生元补充剂与安慰剂或标准护理的疗效。排除标准为非人类研究、非RCT研究和除英语或葡萄牙语以外的语言研究。查阅了六个数据库，包括Cochrane Library、PubMed、Scopus、Cinahl、MedicLatina和Web of Science，截至2023年5月。使用RAYYAN软件管理搜索结果，并依据Cochrane协作网指南，使用Rob 2.0工具评估偏倚风险。结果：符合纳入标准的24项RCT被纳入本综述。前、后或合生元的补充剂改善了手术结果，如术后感染和非感染性并发症的发生率、恢复正常肠道功能、住院时长和抗生素使用。这些微生物的补充剂还缓解了化疗和放疗的一些症状，主要是腹泻。关于最佳菌株类型、剂量和干预持续时间的方法学证据仍然不足。结论：前、后和合生元的补充剂似乎是一种有益的治疗方法，可以改善CRC治疗中的手术结果，并减轻治疗毒性等副作用。需要更多大样本、异质性较小的RCT来证实这些潜在益处，并确定每种情况下的最佳菌株、剂量和给药持续时间。系统综述注册：https://www.crd.york.ac.uk/prospero，标识符CRD42023413958。