Background:Breast cancer remains the leading cause of cancer-related deaths among women despite advances in early detection. Neoadjuvant chemotherapy (NACT) is now standard for early-stage BC, with vitamin D (VD) emerging as a potential prognostic biomarker considering its positive pleiotropic effects. This review and meta-analysis assess the impact of baseline VD levels on outcomes in BC patients undergoing NACT.Methods:Inclusion criteria required patients to be over 18 years of age, have a pathologically confirmed BC diagnosis, and have their VD levels assessed prior to chemotherapy. Studies were included if they reported odds ratios (ORs) for response and/or hazard ratios (HRs) for PFS with 95% confidence intervals (CIs). A comprehensive literature search of PubMed/MEDLINE and Scopus/ELSEVIER (2014–2024) was conducted, and data were analyzed using fixed- and random-effects models, with Forest plots illustrating the results. Study quality and potential biases were assessed using the MINORS, NOS, and RoB2 scales, and statistical heterogeneity was evaluated with I2statistics and funnel plots.Results:Six studies were included in the analysis. All studies addressed stages II and III, with three also including stage I. The meta-analysis covered data from 722 patients regarding NACT response and 1033 patients for PFS. The results revealed a 22% reduction in the likelihood of non-response to NACT associated with adequate VD levels (low/deficient VD vs. high/sufficient VD; OR: 0.78; 95% CI: 0.30–1.25;p= 0.001) and a 35% reduction in progression risk with sufficient baseline VD levels (low/deficient VD vs. high/sufficient VD; HR: 0.65; 95% CI: 0.33–0.97;p< 0.001).Conclusions:These findings highlight the significance of maintaining adequate vitamin D levels in BC treatment and encourage further studies to unravel the role of VD on cancer biology.
背景：尽管早期检测技术有所进步，乳腺癌仍是女性癌症相关死亡的主要原因。新辅助化疗现已成为早期乳腺癌的标准治疗方案，而维生素D因其积极的多效性作用，正逐渐成为一种潜在的预后生物标志物。本综述与荟萃分析旨在评估基线维生素D水平对接受新辅助化疗的乳腺癌患者预后的影响。 方法：纳入标准要求患者年龄超过18岁，经病理学确诊为乳腺癌，且在化疗前接受维生素D水平评估。研究需报告治疗反应的比值比和/或无进展生存期的风险比，并附有95%置信区间。通过系统检索PubMed/MEDLINE和Scopus/ELSEVIER数据库（2014-2024年），采用固定效应与随机效应模型进行数据分析，并通过森林图展示结果。研究质量及潜在偏倚采用MINORS、NOS和RoB2量表评估，统计异质性通过I²统计量与漏斗图进行检验。 结果：共纳入六项研究。所有研究均涉及II-III期患者，其中三项同时包含I期病例。荟萃分析涵盖722例患者的新辅助化疗反应数据及1033例患者的无进展生存期数据。结果显示：充足的维生素D水平可使新辅助化疗无应答概率降低22%（维生素D水平低/缺乏组 vs. 高/充足组；OR：0.78；95% CI：0.30-1.25；p=0.001），基线维生素D充足可使疾病进展风险降低35%（维生素D水平低/缺乏组 vs. 高/充足组；HR：0.65；95% CI：0.33-0.97；p<0.001）。 结论：这些发现凸显了维持充足维生素D水平在乳腺癌治疗中的重要意义，并为进一步探索维生素D在癌症生物学中的作用提供了研究依据。
肿瘤(癌症)患者之家