A IMPORTÂNCIA DOS PROBIÓTICOS, PREBIÓTICOS E SIMBIÓTICOS NO TRATAMENTO DO CÂNCER COLORRETAL EM ADULTOS E IDOSOS
Palavras-chave:
Probióticos, Prebióticos, Simbióticos, Câncer Colorretal, Microbiota Intestinal
Resumo
Resumo: Estudos recentes indicam que a composição da microbiota intestinal pode influenciar tanto o desenvolvimento quanto a prevenção do câncer, tornando-se um fator crítico na progressão da doença. No entanto, ainda há lacunas quanto à eficácia específica desses compostos na redução do risco e no suporte terapêutico para pacientes com câncer colorretal. Dessa forma, o presente estudo investigou como a suplementação de probióticos, prebióticos e simbióticos pode contribuir para o tratamento do câncer colorretal em adultos e idosos, avaliando seus potenciais benefícios e mecanismos de ação. Para isso, o desenvolvimento da pesquisa seguiu etapas bem definidas. Buscou-se artigos originais publicados entre 2015 e 2025, nos bancos de dados online PubMed Central, LILACS e SciELO. Portanto, a modulação positiva da microbiota promoveu o aumento de bactérias benéficas, a inibição de microrganismos patogênicos e a elevação de AGCCs, essenciais para a integridade da mucosa intestinal e o controle de processos inflamatórios.
Referências
CHEN, M. et al. Therapeutic approaches to colorectal cancer via strategies based on modulation of gut microbiota. Front Microbiol. v.4, n. 13, p. 01-20, 2022. Disponível em: https://pubmed.ncbi.nlm.nih.gov/35992678/. Acesso em: 24 de mar. de 2025.
CHEN, Y. et al. Probiotics and synbiotics for preventing postoperative infectious complications in colorectal cancer patients: a systematic review and meta-analysis. Techniques in coloproctology, v. 26, n. 6, p. 425–436, jun. 2022. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.1007/s10151-022-02585-1.
CHU, J. R. et al. Prebiotic UG1601 mitigates constipation-related events in association with gut microbiota: A randomized placebo-controlled intervention study. World Journal of Gastroenterology, v. 25, n. 40, p. 6129–6144, 28 out. 2019. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.3748/wjg.v25.i40.6129.
CLARK, M. J.; ROBIEN, K.; SLAVIN, J. L. Effect of prebiotics on biomarkers of colorectal cancer in humans: a systematic review. Nutrition Reviews, v. 70, n. 8, p. 436–443, 26 jul. 2012. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.1111/j.1753-4887.2012.00495.x.
FLESCH, M. et al. Perioperative synbiotics administration decreases postoperative infections in colorectal cancer patients. J. Surg. Oncol., v. 18, n. 7, p. 442-450, 2017. Disponível em: https://pubmed.ncbi.nlm.nih.gov/36158273/. Acesso em: 11 mar. 2025.
GAO, X. et al. Probiotics modify human intestinal mucosa-associated microbiota in patients with colorectal cancer. J. Clin. Gastroenterol., v. 49, n. 7, p. 764-772, 2015. Disponível em: https://pubmed.ncbi.nlm.nih.gov/25941557/. Acesso em: 11 mar. 2025.
HIBBERD, A. A. et al. Intestinal microbiota is altered in patients with colon cancer and modified by probiotic intervention. BMJ Open Gastroenterology, v. 4, n. 1, p. e000145, jul. 2017. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.1136/bmjgast-2017-000145.
HOLSCHER, H. D. et al. Fiber supplementation influences phylogenetic structure and functional capacity of the human intestinal microbiome: follow-up of a randomized controlled trial. The American Journal of Clinical Nutrition, v. 101, n. 1, p. 55–64, 1 jan. 2015. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.3945/ajcn.114.092064.
HUANG, M. et al. Postoperative probiotics administration attenuates gastrointestinal complications and gut microbiota dysbiosis caused by chemotherapy in colorectal cancer patients. Front Microbiol., v. 4, n. 13, p. 01-20, 2023. Disponível em: https://pubmed.ncbi.nlm.nih.gov/35992678/. Acesso em: 24 mar. 2025.
INSTITUTO NACIONAL DO CÂNCER. Estimativa 2023: incidência de câncer no Brasil. Rio de Janeiro, RJ: Instituto Nacional do Câncer, 2022. Disponível em: https://www.inca.gov.br/publicacoes/livros/estimativa-2023-incidencia-de-cancer-no-brasil. Acesso em: 11 mar. 2025.
KHALEEL, S. M. et al. The role of probiotics in colorectal cancer: A review. Journal of Gastrointestinal Cancer, v. 54, n. 4, p. 1202-1211, 2023. Disponível em: https://pubmed.ncbi.nlm.nih.gov/36622515/. Acesso em: 11 mar. 2025.
KVAKOVA, M. et al. Probiotics and postbiotics in colorectal cancer: Prevention and complementary therapy. World Journal of Gastroenterology, v. 28, n. 27, p. 3370-3382, 2022. Disponível em: https://pubmed.ncbi.nlm.nih.gov/36158273/. Acesso em: 11 mar. 2025.
LIANG, Y. et al. Effects of a multi-strain probiotic formula in colorectal cancer: Impact on Fusobacterium nucleatum and Bifidobacterium. Gut Microbes, v. 15, n. 2, p. 200-213, 2023. Disponível em: https://pubmed.ncbi.nlm.nih.gov/36634962/. Acesso em: 24 mar. 2025.
LIU, P. C. et al. Probiotics Reduce Postoperative Infections in Patients Undergoing Colorectal Surgery: A Systematic Review and Meta-Analysis. Gastroenterology Research and Practice, v. 2017, p. 1–9, 2017. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.1155/2017/6029075.
LOUIS, P.; HOLD, G. L.; FLINT, H. J. The gut microbiota, bacterial metabolites and colorectal cancer. Nature Reviews Microbiology, v. 12, n. 10, p. 661-672, 2014. doi: 10.1038/nrmicro3344. Disponível em: https://pubmed.ncbi.nlm.nih.gov/25198138/. Acesso em: 11 mar. 2025.
MIZUTA, M. et al. Perioperative supplementation with bifidobacteria improves postoperative nutritional recovery, inflammatory response, and fecal microbiota in patients undergoing colorectal surgery: a prospective, randomized clinical trial. Bioscience of Microbiota, Food and Health, v. 35, n. 2, p. 77–87, 2016. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.12938/bmfh.2015-017.
MOHEBIAN, A. et al. The effectiveness of yogurt-based probiotics on chemotherapy-induced diarrhea in colorectal cancer patients: A randomized clinical trial. J. Gastrointest. Cancer, v. 54, n. 4, p. 1202-1211, 2023. Disponível em: https://pubmed.ncbi.nlm.nih.gov/36622515/. Acesso em: 11 mar. 2025.
PANDEY, H. et al. Gut microbiota in colorectal cancer: Biological role and therapeutic opportunities. Cancers, v. 15, n. 3, p. 866, 2023. Disponível em: https://www.mdpi.com/2072-6694/15/3/866. Acesso em: 11 mar. 2025.
PARK, J. et al. Effects of probiotics on intestinal function and inflammation markers after colorectal cancer surgery. World J. Gastroenterol., v. 28, n. 4, p. 1124-1135, 2020. Disponível em: https://pubmed.ncbi.nlm.nih.gov/32133645/. Acesso em: 11 mar. 2025.
PITSILLIDES, L. et al. The Effect of Perioperative Administration of Probiotics on Colorectal Cancer Surgery Outcomes. Nutrients, v. 13, n. 5, p. 1451, 25 abr. 2021. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.3390/nu13051451
POLAKOWSKI, C. B. et al. Impact of the preoperative use of synbiotics in colorectal cancer patients: A prospective, randomized, double-blind, placebo-controlled study. Nutrition, v. 58, p. 40–46, fev. 2019. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.1016/j.nut.2018.06.004.
SADAHIRO, S. et al. Comparison between oral antibiotics and probiotics as bowel preparation for elective colon cancer surgery to prevent infection: Prospective randomized trial. Surgery, v. 155, n. 3, p. 493–503, mar. 2014. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.1016/j.surg.2013.06.002.
SANTOS, M. DE O. et al. Estimativa de incidência de câncer no Brasil, 2023-2025. Revista Brasileira de Cancerologia, v. 69, n. 1, p. 1-15, 6 fev. 2023. Disponível em: https://rbc.inca.gov.br/index.php/revista/article/view/3700. Acesso em: 11 mar. 2025.
SIEGEL, R. L. et al. Colorectal cancer statistics, 2020. CA: A Cancer Journal for Clinicians, v. 70, n. 3, p. 145-164, mar. 2020. Disponível em: https://pubmed.ncbi.nlm.nih.gov/32133645/. Acesso em: 11 mar. 2025.
SILVEIRA, R. C. DE C. P.; GALVÃO, C. M. O cuidado de enfermagem e o cateter de Hickman: a busca de evidências. Acta Paulista de Enfermagem, v. 18, p. 276-284, 1 set. 2005. Disponível em: https://www.scielo.br/j/ape/a/KBW9WsfzTKZh6DKgYSNDPYq/abstract/?lang=pt. Acesso em: 11 mar. 2025.
SONG, M.; GARRETT, W. S.; CHAN, A. T. Nutrients, foods, and colorectal cancer prevention. Gastroenterology, v. 148, n. 6, p. 1244-1260, 2015. doi: 10.1053/j.gastro.2014.12.035. Disponível em: https://doi.org/10.1053/j.gastro.2014.12.035. Acesso em: 11 mar. 2025.
SOUZA, M. T. DE; SILVA, M. D. DA; CARVALHO, R. DE. Integrative review: What is it? How to do it? Einstein (São Paulo), v. 8, n. 1, p. 102-106, mar. 2010. Disponível em: https://journal.einstein.br/pt-br/article/revisao-integrativa-o-que-e-e-como-fazer/. Acesso em: 11 mar. 2025.
STENE, C. et al. Synbiotics protected radiation-induced tissue damage in rectal cancer patients: a controlled trial. Clinical Nutrition, 1 abr. 2025. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.1016/j.clnu.2025.03.025.
TAN, Z. et al. Pre-surgical administration of microbial cell preparation in colorectal cancer patients: A randomized controlled trial. J. Colorectal Cancer, v. 12, n. 5, p. 1067-1074, 2016. Disponível em: https://pubmed.ncbi.nlm.nih.gov/27631934/. Acesso em: 11 mar. 2025.
WILMS, E. et al. Galacto-oligosaccharides supplementation in prefrail older and healthy adults increased faecal bifidobacteria, but did not impact immune function and oxidative stress. Clinical Nutrition, v. 40, n. 5, p. 3019–3031, maio 2021. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.1016/j.clnu.2020.12.034.
XIE, X. et al. Effects of prebiotics on immunologic indicators and intestinal microbiota structure in perioperative colorectal cancer patients. Nutrition, v. 61, p. 132–142, maio 2019. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.1016/j.nut.2018.10.038.
ZENG, J. et al. The effect of pro/synbiotics on postoperative infections in colorectal cancer patients: A systematic review and meta-analysis. Complementary Therapies in Clinical Practice, v. 43, p. 101370–101370, 2 abr. 2021. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.1016/j.ctcp.2021.101370.
CHEN, Y. et al. Probiotics and synbiotics for preventing postoperative infectious complications in colorectal cancer patients: a systematic review and meta-analysis. Techniques in coloproctology, v. 26, n. 6, p. 425–436, jun. 2022. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.1007/s10151-022-02585-1.
CHU, J. R. et al. Prebiotic UG1601 mitigates constipation-related events in association with gut microbiota: A randomized placebo-controlled intervention study. World Journal of Gastroenterology, v. 25, n. 40, p. 6129–6144, 28 out. 2019. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.3748/wjg.v25.i40.6129.
CLARK, M. J.; ROBIEN, K.; SLAVIN, J. L. Effect of prebiotics on biomarkers of colorectal cancer in humans: a systematic review. Nutrition Reviews, v. 70, n. 8, p. 436–443, 26 jul. 2012. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.1111/j.1753-4887.2012.00495.x.
FLESCH, M. et al. Perioperative synbiotics administration decreases postoperative infections in colorectal cancer patients. J. Surg. Oncol., v. 18, n. 7, p. 442-450, 2017. Disponível em: https://pubmed.ncbi.nlm.nih.gov/36158273/. Acesso em: 11 mar. 2025.
GAO, X. et al. Probiotics modify human intestinal mucosa-associated microbiota in patients with colorectal cancer. J. Clin. Gastroenterol., v. 49, n. 7, p. 764-772, 2015. Disponível em: https://pubmed.ncbi.nlm.nih.gov/25941557/. Acesso em: 11 mar. 2025.
HIBBERD, A. A. et al. Intestinal microbiota is altered in patients with colon cancer and modified by probiotic intervention. BMJ Open Gastroenterology, v. 4, n. 1, p. e000145, jul. 2017. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.1136/bmjgast-2017-000145.
HOLSCHER, H. D. et al. Fiber supplementation influences phylogenetic structure and functional capacity of the human intestinal microbiome: follow-up of a randomized controlled trial. The American Journal of Clinical Nutrition, v. 101, n. 1, p. 55–64, 1 jan. 2015. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.3945/ajcn.114.092064.
HUANG, M. et al. Postoperative probiotics administration attenuates gastrointestinal complications and gut microbiota dysbiosis caused by chemotherapy in colorectal cancer patients. Front Microbiol., v. 4, n. 13, p. 01-20, 2023. Disponível em: https://pubmed.ncbi.nlm.nih.gov/35992678/. Acesso em: 24 mar. 2025.
INSTITUTO NACIONAL DO CÂNCER. Estimativa 2023: incidência de câncer no Brasil. Rio de Janeiro, RJ: Instituto Nacional do Câncer, 2022. Disponível em: https://www.inca.gov.br/publicacoes/livros/estimativa-2023-incidencia-de-cancer-no-brasil. Acesso em: 11 mar. 2025.
KHALEEL, S. M. et al. The role of probiotics in colorectal cancer: A review. Journal of Gastrointestinal Cancer, v. 54, n. 4, p. 1202-1211, 2023. Disponível em: https://pubmed.ncbi.nlm.nih.gov/36622515/. Acesso em: 11 mar. 2025.
KVAKOVA, M. et al. Probiotics and postbiotics in colorectal cancer: Prevention and complementary therapy. World Journal of Gastroenterology, v. 28, n. 27, p. 3370-3382, 2022. Disponível em: https://pubmed.ncbi.nlm.nih.gov/36158273/. Acesso em: 11 mar. 2025.
LIANG, Y. et al. Effects of a multi-strain probiotic formula in colorectal cancer: Impact on Fusobacterium nucleatum and Bifidobacterium. Gut Microbes, v. 15, n. 2, p. 200-213, 2023. Disponível em: https://pubmed.ncbi.nlm.nih.gov/36634962/. Acesso em: 24 mar. 2025.
LIU, P. C. et al. Probiotics Reduce Postoperative Infections in Patients Undergoing Colorectal Surgery: A Systematic Review and Meta-Analysis. Gastroenterology Research and Practice, v. 2017, p. 1–9, 2017. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.1155/2017/6029075.
LOUIS, P.; HOLD, G. L.; FLINT, H. J. The gut microbiota, bacterial metabolites and colorectal cancer. Nature Reviews Microbiology, v. 12, n. 10, p. 661-672, 2014. doi: 10.1038/nrmicro3344. Disponível em: https://pubmed.ncbi.nlm.nih.gov/25198138/. Acesso em: 11 mar. 2025.
MIZUTA, M. et al. Perioperative supplementation with bifidobacteria improves postoperative nutritional recovery, inflammatory response, and fecal microbiota in patients undergoing colorectal surgery: a prospective, randomized clinical trial. Bioscience of Microbiota, Food and Health, v. 35, n. 2, p. 77–87, 2016. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.12938/bmfh.2015-017.
MOHEBIAN, A. et al. The effectiveness of yogurt-based probiotics on chemotherapy-induced diarrhea in colorectal cancer patients: A randomized clinical trial. J. Gastrointest. Cancer, v. 54, n. 4, p. 1202-1211, 2023. Disponível em: https://pubmed.ncbi.nlm.nih.gov/36622515/. Acesso em: 11 mar. 2025.
PANDEY, H. et al. Gut microbiota in colorectal cancer: Biological role and therapeutic opportunities. Cancers, v. 15, n. 3, p. 866, 2023. Disponível em: https://www.mdpi.com/2072-6694/15/3/866. Acesso em: 11 mar. 2025.
PARK, J. et al. Effects of probiotics on intestinal function and inflammation markers after colorectal cancer surgery. World J. Gastroenterol., v. 28, n. 4, p. 1124-1135, 2020. Disponível em: https://pubmed.ncbi.nlm.nih.gov/32133645/. Acesso em: 11 mar. 2025.
PITSILLIDES, L. et al. The Effect of Perioperative Administration of Probiotics on Colorectal Cancer Surgery Outcomes. Nutrients, v. 13, n. 5, p. 1451, 25 abr. 2021. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.3390/nu13051451
POLAKOWSKI, C. B. et al. Impact of the preoperative use of synbiotics in colorectal cancer patients: A prospective, randomized, double-blind, placebo-controlled study. Nutrition, v. 58, p. 40–46, fev. 2019. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.1016/j.nut.2018.06.004.
SADAHIRO, S. et al. Comparison between oral antibiotics and probiotics as bowel preparation for elective colon cancer surgery to prevent infection: Prospective randomized trial. Surgery, v. 155, n. 3, p. 493–503, mar. 2014. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.1016/j.surg.2013.06.002.
SANTOS, M. DE O. et al. Estimativa de incidência de câncer no Brasil, 2023-2025. Revista Brasileira de Cancerologia, v. 69, n. 1, p. 1-15, 6 fev. 2023. Disponível em: https://rbc.inca.gov.br/index.php/revista/article/view/3700. Acesso em: 11 mar. 2025.
SIEGEL, R. L. et al. Colorectal cancer statistics, 2020. CA: A Cancer Journal for Clinicians, v. 70, n. 3, p. 145-164, mar. 2020. Disponível em: https://pubmed.ncbi.nlm.nih.gov/32133645/. Acesso em: 11 mar. 2025.
SILVEIRA, R. C. DE C. P.; GALVÃO, C. M. O cuidado de enfermagem e o cateter de Hickman: a busca de evidências. Acta Paulista de Enfermagem, v. 18, p. 276-284, 1 set. 2005. Disponível em: https://www.scielo.br/j/ape/a/KBW9WsfzTKZh6DKgYSNDPYq/abstract/?lang=pt. Acesso em: 11 mar. 2025.
SONG, M.; GARRETT, W. S.; CHAN, A. T. Nutrients, foods, and colorectal cancer prevention. Gastroenterology, v. 148, n. 6, p. 1244-1260, 2015. doi: 10.1053/j.gastro.2014.12.035. Disponível em: https://doi.org/10.1053/j.gastro.2014.12.035. Acesso em: 11 mar. 2025.
SOUZA, M. T. DE; SILVA, M. D. DA; CARVALHO, R. DE. Integrative review: What is it? How to do it? Einstein (São Paulo), v. 8, n. 1, p. 102-106, mar. 2010. Disponível em: https://journal.einstein.br/pt-br/article/revisao-integrativa-o-que-e-e-como-fazer/. Acesso em: 11 mar. 2025.
STENE, C. et al. Synbiotics protected radiation-induced tissue damage in rectal cancer patients: a controlled trial. Clinical Nutrition, 1 abr. 2025. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.1016/j.clnu.2025.03.025.
TAN, Z. et al. Pre-surgical administration of microbial cell preparation in colorectal cancer patients: A randomized controlled trial. J. Colorectal Cancer, v. 12, n. 5, p. 1067-1074, 2016. Disponível em: https://pubmed.ncbi.nlm.nih.gov/27631934/. Acesso em: 11 mar. 2025.
WILMS, E. et al. Galacto-oligosaccharides supplementation in prefrail older and healthy adults increased faecal bifidobacteria, but did not impact immune function and oxidative stress. Clinical Nutrition, v. 40, n. 5, p. 3019–3031, maio 2021. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.1016/j.clnu.2020.12.034.
XIE, X. et al. Effects of prebiotics on immunologic indicators and intestinal microbiota structure in perioperative colorectal cancer patients. Nutrition, v. 61, p. 132–142, maio 2019. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.1016/j.nut.2018.10.038.
ZENG, J. et al. The effect of pro/synbiotics on postoperative infections in colorectal cancer patients: A systematic review and meta-analysis. Complementary Therapies in Clinical Practice, v. 43, p. 101370–101370, 2 abr. 2021. Acesso em: 26 de maio de 2025. Disponível em: https://doi.org/10.1016/j.ctcp.2021.101370.
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2025-12-17
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