title: Prognostic role of vitamin d status and efficacy of vitamin D supplementation in cancer patients: a systematic review.
abstract: BACKGROUND
  Whether or not hypovitaminosis D can influence the prognosis of cancer patients and whether or not vitamin D (vitD) supplementation improves outcome remain controversial.
  
  
  METHODS
  Studies evaluating the prognostic role of vitD and vitD receptor (VDR) in cancer patients and trials evaluating the efficacy of vitD administration on patient outcome were identified by a search of MEDLINE, EMBASE, ISI Web of Knowledge, and the Cochrane Library through June 2010.
  
  
  RESULTS
  Twenty-five studies were included. A negative prognostic role for low serum vitD level was observed in five cohort studies including patients with breast cancer (one study), colon cancer (two studies), prostate cancer (one study), and melanoma (one study), but not in two studies on non-small cell lung cancer and one study on breast cancer. Three of four studies showed that VDR(+) tumors carry a better prognosis than VDR(-) tumors, whereas VDR polymorphisms were significantly associated with prognosis in five of 10 studies. A significant interaction between serum vitD level and VDR polymorphism was observed in one study. Three randomized trials involving advanced prostate cancer patients explored the prognostic role of vitD supplementation. A meta-analysis of these trials showed no effect on survival (pooled risk ratio, 1.07; 95% confidence interval, CI, 0.93-1.23), with strong heterogeneity among studies.
  
  
  CONCLUSIONS
  Hypovitaminosis D seems to be associated with a worse prognosis in some cancers, but vitD supplementation failed to demonstrate a benefit in prostate cancer patients. The currently available evidence is insufficient to recommend vitD supplementation in cancer patients in clinical practice.
authors.affiliation: Oncologia Medica, Ospedale San Luigi, Regione Gonzole 10, 10043 Orbassano, Italy.
authors.forename: Consuelo
authors.initials: C
authors.lastname: Buttigliero
authors.forename: Chiara
authors.initials: C
authors.lastname: Monagheddu
authors.forename: Paola
authors.initials: P
authors.lastname: Petroni
authors.forename: Andrea
authors.initials: A
authors.lastname: Saini
authors.forename: Luigi
authors.initials: L
authors.lastname: Dogliotti
authors.forename: Giovannino
authors.initials: G
authors.lastname: Ciccone
authors.forename: Alfredo
authors.initials: A
authors.lastname: Berruti
mesh_terms: D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000097:blood* / Q000188:drug therapy*; D011379:Prognosis; D011446:Prospective Studies; D014807:Vitamin D / Q000008:administration & dosage* / Q000097:blood*
chemical_list: D014807:Vitamin D