Djavan Bob, Zlotta Alexandre, Schulman Claude, Teillac Pierre, Iversen Peter, Boccon Gibod Laurent, Bartsch Georg, Marberger Michael
Department of Urology, Prostate Disease Center, Ludwig Boltzmand Institute for Prostatic disease, University of Vienna, Wahringer Gurtel 18-20, 1090, Austria.
J Urol. 2004 Feb;171(2 Pt 2):S10-3; discussion S13-4. doi: 10.1097/01.ju.0000108221.63466.7d.
Despite advances in the detection and management of prostate cancer, this disease remains a major cause of morbidity and mortality in men. Increasing attention has focused on the role of chemoprevention for prostate cancer, ie the administration of agents that inhibit 1 or more steps in the natural history of prostate carcinogenesis. We review prostate cancer chemoprevention studies in Europe.
Published studies were identified in a search of MEDLINE. Information about ongoing studies was provided by author access to protocols.
A variety of chemoprevention studies have focused on the role of dietary factors, vitamins and trace elements in prostate cancer. Some of these studies have been prospective, randomized and double-blinded, while others have used retrospective or epidemiological approaches. Large scale randomized studies are also evaluating the role of 5alpha-reductase inhibitors, which inhibit the conversion of testosterone to the more potent androgen dihydrotestosterone.
Robust evidence is lacking for the value of chemopreventive agents in prostate cancer. Current evidence does suggest that vitamin E and selenium may have a role in prostate cancer chemoprevention. Data from 2 studies, 1 examining the type 1 5alpha-reductase selective inhibitor finasteride and the other using the dual 5alpha-reductase inhibitor dutasteride, will determine the benefits of androgen inhibition strategies for prostate cancer chemoprevention.
尽管前列腺癌的检测和管理取得了进展，但该疾病仍然是男性发病和死亡的主要原因。越来越多的关注集中在前列腺癌化学预防的作用上，即给予能够抑制前列腺癌发生自然史中一个或多个步骤的药物。我们回顾欧洲的前列腺癌化学预防研究。
通过检索MEDLINE确定已发表的研究。正在进行的研究信息由作者获取方案提供。
各种化学预防研究聚焦于饮食因素、维生素和微量元素在前列腺癌中的作用。其中一些研究是前瞻性、随机和双盲的，而其他研究则采用回顾性或流行病学方法。大规模随机研究也在评估5α还原酶抑制剂的作用，该抑制剂可抑制睾酮转化为更强效的雄激素双氢睾酮。
缺乏关于化学预防药物在前列腺癌中价值的有力证据。目前的证据确实表明维生素E和硒可能在前列腺癌化学预防中发挥作用。两项研究的数据，一项研究1型5α还原酶选择性抑制剂非那雄胺，另一项使用双重5α还原酶抑制剂度他雄胺，将确定雄激素抑制策略对前列腺癌化学预防的益处。
