The Role of Probiotics in Oral Squamous Cell Carcinoma: A Comprehensive Review

Oral squamous cell carcinoma (OSCC) accounts for over ۹۰% of oral cancers and has a poor prognosis despite conventional treatments. Recent evidence highlights the role of oral microbiome dysbiosis in OSCC development. Probiotics, particularly Lactobacillus and Bifidobacterium species, have shown anticancer, anti-inflammatory, and immunomodulatory effects in various malignancies. This review examines in-vitro and clinical evidence on probiotics in OSCC management. A narrative search of PubMed, Scopus, and Web of Science was conducted up to November ۲۰۲۵, following PRISMA guidelines. Studies involving OSCC cell lines and clinical trials of probiotic supplementation were included. Reviews, case reports, and non-English articles were excluded. Data extracted included probiotic strains, mechanisms, outcomes, and safety. In-vitro studies revealed that Lactobacillus rhamnosus GG, L. plantarum, L. casei Shirota, and Bifidobacterium lactis inhibited OSCC cell proliferation, induced apoptosis, suppressed epithelial-mesenchymal transition, and downregulated pro-tumor inflammatory pathways such as NF-κB, IL-۶/STAT۳, and TLR-۴. Animal models demonstrated reduced tumor incidence and size following probiotic treatment, accompanied by enhanced antitumor immunity (increased CD۸+ T cells and IFN-y). Clinical trials reported reductions in radiotherapy-induced oral mucositis, improved oral microbial diversity, and enhanced systemic immunity, including increased salivary IgA and decreased CRP levels. No direct tumor shrinkage was observed. Adverse events were minimal. Probiotics show promise as adjuncts in OSCC management by mitigating treatment-related toxicity and modulating immunity and microbiota. Nonetheless, clinical evidence for direct anticancer effects remains limited. Well-designed randomized controlled trials are needed to confirm their efficacy and safety.

کلیدواژه ها:

Oral squamous cell carcinoma ، probiotics ، microbiome modulation ، Lactobacillus