Table 2.
Characteristics and results of the randomised controlled trials of diet/nutrition interventions and health-related quality of life (HRQoL) and cancer-related fatigue in colorectal cancer survivors
| Author, year Country |
Intervention and comparator details | Timeframe Time point |
Int n/Ctrl n | Cancer site, stage | Global/total HRQoL score |
Physical/functional HRQoL score |
Emotional/mental HRQoL score |
Total cancer-related fatigue |
|||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EORTC-QLQ-C30 | FACT-G | FACT-C | FACIT-F | SF-12/36 | GIQLI | EORTC-QLQ-C30 | FACT-G | FACT-C | SF-12/36 | GIQLI | EORTC-QLQ-C30 | FACT-G | FACT-C | SF-12/36 | GIQLI | EORTC-QLQ-C30 | FACIT-F | BFI | |||||
| Diet/nutrition | |||||||||||||||||||||||
| Wang, 202343 USA |
Web-based counselling versus wait list | During/after treatment 24 weeks |
22/20 | CRC I-IV |
−4.0 −13.7 to 5.7) | ─ | ─ | ─ | ─ | ─ | 0.0 (−3.9 to 3.9) | ─ | ─ | ─ | ─ | 7.2 (−4.7 to 19.1) | ─ | ─ | ─ | ─ | −4.1 (−15.8 to 7.6) | ─ | ─ |
| Wang, 202244 China |
Personalised nutrition versus usual care | During/after treatment 6 months |
28/28 | CRC I-III |
29.8 (27.6-32) | ─ | ─ | ─ | ─ | ─ | 17.6 (15.7-19.6) | ─ | ─ | ─ | ─ | 28 (25.3, 30.7) | ─ | ─ | ─ | ─ | −39.3 (−41.7 to −36.9) | ─ | ─ |
| Ho, 202032 China |
Diet versus usual care (± PA) | After treatment 24 months |
111/112 | CRC I-IV |
─ | 3.1 (0.2-6) | 3.3 (−0.4 to 7) | ─ | ─ | ─ | ─ | ─ | ─ | 2.6 (0.7-4.5) | ─ | ─ | ─ | ─ | 0.4 (−1.6 to 2.4) | ─ | ─ | ─ | ─ |
| Ravasco, 201252 Portugal |
Dietary counselling versus usual care | During treatment 6.5 years |
34/26 | CRC I-IV |
P < 0.002a,b | ─ | ─ | ─ | ─ | ─ | P < 0.002a,b | ─ | ─ | ─ | ─ | P < 0.002a,b | ─ | ─ | ─ | ─ | P < 0.002a,b | ─ | ─ |
| Ravasco, 200555 Portugal |
Dietary counselling versus usual care | During treatment 3 months |
37/37 | CRC I-IV |
c | ─ | ─ | ─ | ─ | ─ | c | ─ | ─ | ─ | ─ | c | ─ | ─ | ─ | ─ | c | ─ | ─ |
| Probiotics | |||||||||||||||||||||||
| Yoon, 202145 Korea |
Lactobacillus plantarum versus PBO | Post-operative 3 weeks |
19/17 | REC I-III |
5.5 (−6.4 to 17.4) | ─ | ─ | ─ | ─ | ─ | 2.1 (−6.9 to 11.1) | ─ | ─ | ─ | ─ | ─ | ─ | ─ | ─ | ─ | ─ | ─ | ─ |
| Golkhalkhali, 201847 Malaysia |
MCP + Ω-3 versus PBO | During treatment 6 months |
70/70 | CRC NR |
27.7 (26.8-28.6) | ─ | ─ | ─ | ─ | ─ | 16.9 (15.9-17.9) | ─ | ─ | ─ | ─ | 11.9 (11.1-12.7) | ─ | ─ | ─ | ─ | −25.1 (−26.2 to −24.0) | ─ | ─ |
| Theodoropoulos, 201649 Greece |
LAB versus PBO (+ fibres) | Post-operative 6 months |
38/37 | CRC 0-IV |
─ | ─ | ─ | ─ | ─ | 6.5 (5.7-7.3) | ─ | ─ | ─ | ─ | c | ─ | ─ | ─ | ─ | P > 0.05 | ─ | ─ | ─ |
| Lee, 201451 Korea |
Lactobacillus (Lacidofil®) versus PBO | After treatment 12 weeks |
28/32 | CRC II-III |
─ | −3.5 (−11.3 to 4.3) | 1.0 (−1.1 to 3.1) | ─ | ─ | ─ | ─ | −1.0 (−30 to 1.0) | ─ | ─ | ─ | ─ | −0.5 (−2.7 to 1.7) | ─ | ─ | ─ | ─ | 0.5 (−0.1 to 1.1) | ─ |
| Can, 200953 Turkey |
Kefir versus control | During treatment 6 cycles |
17/20 | CRC II-IV |
─ | −3.1 (−11.8 to 5.6) | ─ | ─ | ─ | ─ | ─ | 0.4 (−2.6 to 3.5) | ─ | ─ | ─ | ─ | −1.0 (−3.6 to 1.6) | ─ | ─ | ─ | ─ | ─ | ─ |
| Supplements | |||||||||||||||||||||||
| Kim, 202046 Korea |
Korean red ginseng versus PBO | During treatment 16 weeks |
206/203 | CRC II-IV |
─ | ─ | ─ | 2.1 (−2.9 to 7.2) | ─ | ─ | ─ | ─ | ─ | ─ | ─ | ─ | ─ | ─ | ─ | ─ | ─ | ─ | −4.4 (−9.1 to 0.3) |
| Ribeiro, 201748 Brazil |
Zinc versus PBO | During treatment 4 cycles |
11/14 | CRC II-IV |
─ | ─ | ─ | 7.0 (−9.7 to 23.4) | ─ | ─ | ─ | ─ | ─ | ─ | ─ | c | ─ | ─ | ─ | ─ | ─ | 4.0 (−3.7 to 11.7) | ─ |
| Gillis, 201650 Canada |
Whey versus PBO | Prehab 8 weeks |
22/21 | CRC I-III |
─ | ─ | ─ | ─ | ─ | ─ | ─ | ─ | ─ | ─ | ─ | ─ | ─ | ─ | P = 0.3 | ─ | ─ | ─ | ─ |
| Norman, 200654 Germany |
Creatine monohydrate versus PBO | During treatment 8 weeks |
16/15 | CRC III-IV |
5.3 (2.0-8.6) | ─ | ─ | ─ | ─ | ─ | −2.5 (−5.6 to 0.6) | ─ | ─ | ─ | ─ | 6.4 (1.9-10.9) | ─ | ─ | ─ | ─ | −4.6 (−8.9 to −0.3) | ─ | ─ |
| Ravasco, 201252 Portugal |
Protein versus usual care | During treatment 6.5 years |
29/26 | CRC I-IV |
a,b | ─ | ─ | ─ | ─ | ─ | a,b | ─ | ─ | ─ | ─ | a,b | ─ | ─ | ─ | ─ | a,b | ─ | ─ |
| Ravasco, 200555 Portugal |
Protein versus usual care | During treatment 3 months |
37/37 | CRC I-IV |
c | ─ | ─ | ─ | ─ | ─ | c | ─ | ─ | ─ | ─ | c | ─ | ─ | ─ | ─ | c | ─ | ─ |
Results are reported as unstandardised mean difference (95% confidence interval), unless otherwise specified. P values are reported when no other measure of effect was provided.
Black: Trivial/ not significant/ non-evaluable effect.
Dark blue: Large positive effect; Light blue: Medium positive effect; Dark green: Clinically relevant positive effect; Light green: Small positive effect.
BFI, Brief Fatigue Inventory; CRC, colorectal; Ctrl, control; cy, cycles; EORTC-QLQ-C30, European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30; FACIT-F, Functional Assessment of Chronic Illness Therapy-Fatigue; FACT-C, Functional Assessment of Cancer Therapy-Colorectal; FACT-G, Functional Assessment of Cancer Therapy-General; GIQLI, Gastrointestinal Quality of Life Index; Int, intervention; LAB, lactic acid bacteria; NR, not reported; PA, physical activity; PBO, placebo; Prehab, prehabilitation; REC, rectum; SF-12/36, Medical Outcomes Study Short Form 12/36 Health Survey.
Difference between counselling and control, no difference between supplements and control, effect not reported but narratively described.
Mean/median change difference.
Assessed but not formally analysed.