Division of Urologic Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
Semin Oncol. 2013 Jun;40(3):276-85. doi: 10.1053/j.seminoncol.2013.04.003.
Prostate cancer is a leading cause of morbidity and mortality in men and has significant treatment-associated complications. Prostate cancer chemoprevention has the potential to decrease the morbidity and mortality associated with this disease. Chemoprevention research to date has primarily focused on nutrients and 5 alpha-reductase inhibitors (5ARIs). A large randomized trial (SELECT) found no favorable effect of selenium or vitamin E on prostate cancer prevention. Two large randomized placebo controlled trials (the PCPT and REDUCE trials) have been published and have supported the role of 5ARIs in prostate cancer chemoprevention; however, these trials also have prompted concerns regarding the increase in high-grade disease seen with treatment and have not been approved by the US Food and Drug Administration (FDA) for chemoprevention. Conclusive evidence for the chemopreventive benefit of nutrients or vitamins is lacking, whereas the future role of 5ARIs remains to be clarified.
前列腺癌是男性发病率和死亡率的主要原因，并且与治疗相关的并发症有显著影响。前列腺癌的化学预防有降低与这种疾病相关的发病率和死亡率的潜力。迄今为止，化学预防研究主要集中在营养物质和 5α-还原酶抑制剂（5ARIs）上。一项大型随机试验（SELECT）发现硒或维生素 E 对预防前列腺癌没有有利影响。两项大型随机安慰剂对照试验（PCPT 和 REDUCE 试验）已经发表，并支持 5ARIs 在前列腺癌化学预防中的作用；然而，这些试验也引起了人们对治疗中看到的高级别疾病增加的关注，并且尚未被美国食品和药物管理局（FDA）批准用于化学预防。缺乏营养物质或维生素具有化学预防益处的确凿证据，而 5ARIs 的未来作用仍有待阐明。
