Selenium and Lung Cancer: A Systematic Review and Meta Analysis
Identifieur interne : 002D45 ( Pmc/Checkpoint ); précédent : 002D44; suivant : 002D46Selenium and Lung Cancer: A Systematic Review and Meta Analysis
Auteurs : Heidi Fritz [Canada] ; Deborah Kennedy [Canada] ; Dean Fergusson [Canada] ; Rochelle Fernandes [Canada] ; Kieran Cooley [Canada] ; Andrew Seely [Canada] ; Stephen Sagar [Canada] ; Raimond Wong [Canada] ; Dugald Seely [Canada]Source :
- PLoS ONE [ 1932-6203 ] ; 2011.
Abstract
Selenium is a natural health product widely used in the treatment and prevention of lung cancers, but large chemoprevention trials have yielded conflicting results. We conducted a systematic review of selenium for lung cancers, and assessed potential interactions with conventional therapies.
Two independent reviewers searched six databases from inception to March 2009 for evidence pertaining to the safety and efficacy of selenium for lung cancers. Pubmed and EMBASE were searched to October 2009 for evidence on interactions with chemo- or radiation-therapy. In the efficacy analysis there were nine reports of five RCTs and two biomarker-based studies, 29 reports of 26 observational studies, and 41 preclinical studies. Fifteen human studies, one case report, and 36 preclinical studies were included in the interactions analysis. Based on available evidence, there appears to be a different chemopreventive effect dependent on baseline selenium status, such that selenium supplementation may reduce risk of lung cancers in populations with lower baseline selenium status (serum<106 ng/mL), but increase risk of lung cancers in those with higher selenium (≥121.6 ng/mL). Pooling data from two trials yielded no impact to odds of lung cancer, OR 0.93 (95% confidence interval 0.61–1.43); other cancers that were the primary endpoints of these trials, OR 1.51 (95%CI 0.70–3.24); and all-cause-death, OR 0.93 (95%CI 0.79–1.10). In the treatment of lung cancers, selenium may reduce cisplatin-induced nephrotoxicity and side effects associated with radiation therapy.
Selenium may be effective for lung cancer prevention among individuals with lower selenium status, but at present should not be used as a general strategy for lung cancer prevention. Although promising, more evidence on the ability of selenium to reduce cisplatin and radiation therapy toxicity is required to ensure that therapeutic efficacy is maintained before any broad clinical recommendations can be made in this context.
Url:
DOI: 10.1371/journal.pone.0026259
PubMed: 22073154
PubMed Central: 3208545
Affiliations:
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Selenium is a natural health product widely used in the treatment and prevention of lung cancers, but large chemoprevention trials have yielded conflicting results. We conducted a systematic review of selenium for lung cancers, and assessed potential interactions with conventional therapies.</p>
</sec>
<sec><title>Methods and Findings</title>
<p>Two independent reviewers searched six databases from inception to March 2009 for evidence pertaining to the safety and efficacy of selenium for lung cancers. Pubmed and EMBASE were searched to October 2009 for evidence on interactions with chemo- or radiation-therapy. In the efficacy analysis there were nine reports of five RCTs and two biomarker-based studies, 29 reports of 26 observational studies, and 41 preclinical studies. Fifteen human studies, one case report, and 36 preclinical studies were included in the interactions analysis. Based on available evidence, there appears to be a different chemopreventive effect dependent on baseline selenium status, such that selenium supplementation may reduce risk of lung cancers in populations with lower baseline selenium status (serum<106 ng/mL), but increase risk of lung cancers in those with higher selenium (≥121.6 ng/mL). Pooling data from two trials yielded no impact to odds of lung cancer, OR 0.93 (95% confidence interval 0.61–1.43); other cancers that were the primary endpoints of these trials, OR 1.51 (95%CI 0.70–3.24); and all-cause-death, OR 0.93 (95%CI 0.79–1.10). In the treatment of lung cancers, selenium may reduce cisplatin-induced nephrotoxicity and side effects associated with radiation therapy.</p>
</sec>
<sec><title>Conclusions</title>
<p>Selenium may be effective for lung cancer prevention among individuals with lower selenium status, but at present should not be used as a general strategy for lung cancer prevention. Although promising, more evidence on the ability of selenium to reduce cisplatin and radiation therapy toxicity is required to ensure that therapeutic efficacy is maintained before any broad clinical recommendations can be made in this context.</p>
</sec>
</div>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id>
<journal-id journal-id-type="publisher-id">plos</journal-id>
<journal-id journal-id-type="pmc">plosone</journal-id>
<journal-title-group><journal-title>PLoS ONE</journal-title>
</journal-title-group>
<issn pub-type="epub">1932-6203</issn>
<publisher><publisher-name>Public Library of Science</publisher-name>
<publisher-loc>San Francisco, USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">22073154</article-id>
<article-id pub-id-type="pmc">3208545</article-id>
<article-id pub-id-type="publisher-id">PONE-D-11-09686</article-id>
<article-id pub-id-type="doi">10.1371/journal.pone.0026259</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
<subj-group subj-group-type="Discipline-v2"><subject>Biology</subject>
<subj-group><subject>Toxicology</subject>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v2"><subject>Medicine</subject>
<subj-group><subject>Clinical Research Design</subject>
<subj-group><subject>Systematic Reviews</subject>
</subj-group>
</subj-group>
<subj-group><subject>Complementary and Alternative Medicine</subject>
</subj-group>
<subj-group><subject>Nutrition</subject>
<subj-group><subject>Micronutrient Deficiencies</subject>
</subj-group>
</subj-group>
<subj-group><subject>Oncology</subject>
<subj-group><subject>Cancer Risk Factors</subject>
<subj-group><subject>Chemoprevention</subject>
</subj-group>
</subj-group>
<subj-group><subject>Cancer Treatment</subject>
<subj-group><subject>Complementary and Alternative Medicine</subject>
</subj-group>
</subj-group>
<subj-group><subject>Cancers and Neoplasms</subject>
<subj-group><subject>Lung and Intrathoracic Tumors</subject>
</subj-group>
</subj-group>
<subj-group><subject>Cancer Prevention</subject>
</subj-group>
</subj-group>
<subj-group><subject>Toxicology</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group><article-title>Selenium and Lung Cancer: A Systematic Review and Meta Analysis</article-title>
<alt-title alt-title-type="running-head">Selenium and Lung Cancer</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Fritz</surname>
<given-names>Heidi</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kennedy</surname>
<given-names>Deborah</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Fergusson</surname>
<given-names>Dean</given-names>
</name>
<xref ref-type="aff" rid="aff4"><sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Fernandes</surname>
<given-names>Rochelle</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff3"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Cooley</surname>
<given-names>Kieran</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Seely</surname>
<given-names>Andrew</given-names>
</name>
<xref ref-type="aff" rid="aff5"><sup>5</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sagar</surname>
<given-names>Stephen</given-names>
</name>
<xref ref-type="aff" rid="aff6"><sup>6</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Wong</surname>
<given-names>Raimond</given-names>
</name>
<xref ref-type="aff" rid="aff6"><sup>6</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Seely</surname>
<given-names>Dugald</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff4"><sup>4</sup>
</xref>
<xref ref-type="corresp" rid="cor1"><sup>*</sup>
</xref>
</contrib>
</contrib-group>
<aff id="aff1"><label>1</label>
<addr-line>Department of Research and Epidemiology, The Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada</addr-line>
</aff>
<aff id="aff2"><label>2</label>
<addr-line>Leslie Dan Faculty of Pharmacy, The University of Toronto, Toronto, Ontario, Canada</addr-line>
</aff>
<aff id="aff3"><label>3</label>
<addr-line>Laboratory Medicine and Pathobiology (LMP), The University of Toronto, Toronto, Ontario, Canada</addr-line>
</aff>
<aff id="aff4"><label>4</label>
<addr-line>Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada</addr-line>
</aff>
<aff id="aff5"><label>5</label>
<addr-line>Department of Surgery, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada</addr-line>
</aff>
<aff id="aff6"><label>6</label>
<addr-line>Juravinski Cancer Centre and Department of Medicine, McMaster University, Hamilton, Ontario, Canada</addr-line>
</aff>
<contrib-group><contrib contrib-type="editor"><name><surname>Zhivotovsky</surname>
<given-names>Boris</given-names>
</name>
<role>Editor</role>
<xref ref-type="aff" rid="edit1"></xref>
</contrib>
</contrib-group>
<aff id="edit1">Karolinska Institutet, Sweden</aff>
<author-notes><corresp id="cor1">* E-mail: <email>dseely@ccnm.edu</email>
</corresp>
<fn fn-type="con"><p>Conceived and designed the experiments: DS DF KC AS RW SS HF DAK. Performed the experiments: HF RF DAK. Analyzed the data: DS DF HF DAK. Wrote the paper: HF DAK DS.</p>
</fn>
</author-notes>
<pub-date pub-type="collection"><year>2011</year>
</pub-date>
<pub-date pub-type="epub"><day>4</day>
<month>11</month>
<year>2011</year>
</pub-date>
<volume>6</volume>
<issue>11</issue>
<elocation-id>e26259</elocation-id>
<history><date date-type="received"><day>27</day>
<month>5</month>
<year>2011</year>
</date>
<date date-type="accepted"><day>23</day>
<month>9</month>
<year>2011</year>
</date>
</history>
<permissions><copyright-statement>Fritz et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</copyright-statement>
<copyright-year>2011</copyright-year>
</permissions>
<abstract><sec><title>Background</title>
<p>Selenium is a natural health product widely used in the treatment and prevention of lung cancers, but large chemoprevention trials have yielded conflicting results. We conducted a systematic review of selenium for lung cancers, and assessed potential interactions with conventional therapies.</p>
</sec>
<sec><title>Methods and Findings</title>
<p>Two independent reviewers searched six databases from inception to March 2009 for evidence pertaining to the safety and efficacy of selenium for lung cancers. Pubmed and EMBASE were searched to October 2009 for evidence on interactions with chemo- or radiation-therapy. In the efficacy analysis there were nine reports of five RCTs and two biomarker-based studies, 29 reports of 26 observational studies, and 41 preclinical studies. Fifteen human studies, one case report, and 36 preclinical studies were included in the interactions analysis. Based on available evidence, there appears to be a different chemopreventive effect dependent on baseline selenium status, such that selenium supplementation may reduce risk of lung cancers in populations with lower baseline selenium status (serum<106 ng/mL), but increase risk of lung cancers in those with higher selenium (≥121.6 ng/mL). Pooling data from two trials yielded no impact to odds of lung cancer, OR 0.93 (95% confidence interval 0.61–1.43); other cancers that were the primary endpoints of these trials, OR 1.51 (95%CI 0.70–3.24); and all-cause-death, OR 0.93 (95%CI 0.79–1.10). In the treatment of lung cancers, selenium may reduce cisplatin-induced nephrotoxicity and side effects associated with radiation therapy.</p>
</sec>
<sec><title>Conclusions</title>
<p>Selenium may be effective for lung cancer prevention among individuals with lower selenium status, but at present should not be used as a general strategy for lung cancer prevention. Although promising, more evidence on the ability of selenium to reduce cisplatin and radiation therapy toxicity is required to ensure that therapeutic efficacy is maintained before any broad clinical recommendations can be made in this context.</p>
</sec>
</abstract>
<counts><page-count count="10"></page-count>
</counts>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Canada</li>
</country>
<region><li>Ontario</li>
</region>
<settlement><li>Hamilton (Ontario)</li>
<li>Toronto</li>
</settlement>
<orgName><li>Université McMaster</li>
<li>Université de Toronto</li>
</orgName>
</list>
<tree><country name="Canada"><noRegion><name sortKey="Fritz, Heidi" sort="Fritz, Heidi" uniqKey="Fritz H" first="Heidi" last="Fritz">Heidi Fritz</name>
</noRegion>
<name sortKey="Cooley, Kieran" sort="Cooley, Kieran" uniqKey="Cooley K" first="Kieran" last="Cooley">Kieran Cooley</name>
<name sortKey="Cooley, Kieran" sort="Cooley, Kieran" uniqKey="Cooley K" first="Kieran" last="Cooley">Kieran Cooley</name>
<name sortKey="Fergusson, Dean" sort="Fergusson, Dean" uniqKey="Fergusson D" first="Dean" last="Fergusson">Dean Fergusson</name>
<name sortKey="Fernandes, Rochelle" sort="Fernandes, Rochelle" uniqKey="Fernandes R" first="Rochelle" last="Fernandes">Rochelle Fernandes</name>
<name sortKey="Fernandes, Rochelle" sort="Fernandes, Rochelle" uniqKey="Fernandes R" first="Rochelle" last="Fernandes">Rochelle Fernandes</name>
<name sortKey="Kennedy, Deborah" sort="Kennedy, Deborah" uniqKey="Kennedy D" first="Deborah" last="Kennedy">Deborah Kennedy</name>
<name sortKey="Kennedy, Deborah" sort="Kennedy, Deborah" uniqKey="Kennedy D" first="Deborah" last="Kennedy">Deborah Kennedy</name>
<name sortKey="Sagar, Stephen" sort="Sagar, Stephen" uniqKey="Sagar S" first="Stephen" last="Sagar">Stephen Sagar</name>
<name sortKey="Seely, Andrew" sort="Seely, Andrew" uniqKey="Seely A" first="Andrew" last="Seely">Andrew Seely</name>
<name sortKey="Seely, Dugald" sort="Seely, Dugald" uniqKey="Seely D" first="Dugald" last="Seely">Dugald Seely</name>
<name sortKey="Seely, Dugald" sort="Seely, Dugald" uniqKey="Seely D" first="Dugald" last="Seely">Dugald Seely</name>
<name sortKey="Wong, Raimond" sort="Wong, Raimond" uniqKey="Wong R" first="Raimond" last="Wong">Raimond Wong</name>
</country>
</tree>
</affiliations>
</record>
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