Olumi Aria F
Urol Oncol. 2014 Feb;32(2):210. doi: 10.1016/j.urolonc.2013.08.021.
Vitamin D3 might benefit prostate cancer (PCa) patients because prostate cells can locally synthesize the active hormone calcitriol.
Our objective was to determine the effects of oral vitamin D3 on vitamin D metabolites and PCa proliferative activity in prostate tissue.
We conducted a double-blind randomized clinical trial at surgical oncology clinics in Toronto, Canada.
PCa patients (Gleason 6 or 7) participated in the study. Of 66 subjects who were enrolled, 63 completed the dosing protocol.
Vitamin D3 (400, 10000, or 40000 IU/d) was orally administered before radical prostatectomy.
We evaluated vitamin D metabolite levels and Ki67 labeling in surgical prostate tissue. Safety measures, PTH, and prostate-specific antigen (PSA) were also assessed.
Prostate tissue and serum levels of vitamin D metabolites, including calcitriol, increased dose dependently (P<.03) and were significantly higher in the 40000-IU/d group than in every other dose group (P<.03). Prostate vitamin D metabolites correlated positively with serum levels (P<.0001). Ki67 measures did not differ significantly among vitamin D dose groups. However, cross-sectional analysis indicated that the calcitriol level attained in prostate was inversely associated with Ki67 intensity and Ki67 (3+) percent positive nuclei in PCa and benign tissue (P<.05). Safety measures did not change adversely with dosing. Compared with the 400-IU/d group, serum PTH and PSA were lower in the combined higher-dose groups at the end of the study (P< .02).
Oral vitamin D3 raised prostate calcitriol levels (level 1 evidence) and modestly lowered both PSA and PTH. Although Ki67 expression did not differ among dose groups, its levels correlated inversely with prostate calcitriol. These suggestions of clinical benefit justify continued clinical research.
维生素D3可能对前列腺癌（PCa）患者有益，因为前列腺细胞能够在局部合成活性激素骨化三醇。
我们的目的是确定口服维生素D3对前列腺组织中维生素D代谢产物及PCa增殖活性的影响。
我们在加拿大多伦多的外科肿瘤诊所进行了一项双盲随机临床试验。
PCa患者（Gleason评分为6或7）参与了本研究。在登记的66名受试者中，63名完成了给药方案。
在根治性前列腺切除术之前口服维生素D3（400、10000或40000 IU/天）。
我们评估了手术切除的前列腺组织中维生素D代谢产物水平及Ki67标记情况。还评估了安全指标、甲状旁腺激素（PTH）和前列腺特异性抗原（PSA）。
包括骨化三醇在内的维生素D代谢产物在前列腺组织和血清中的水平呈剂量依赖性升高（P<0.03），且40000 IU/天组显著高于其他各剂量组（P<0.03）。前列腺维生素D代谢产物与血清水平呈正相关（P<0.0001）。Ki67指标在维生素D各剂量组之间无显著差异。然而，横断面分析表明，前列腺中达到的骨化三醇水平与PCa及良性组织中的Ki67强度和Ki67（3+）阳性细胞核百分比呈负相关（P<0.05）。安全指标未因给药而出现不良变化。与400 IU/天组相比，在研究结束时，联合高剂量组的血清PTH和PSA较低（P<0.02）。
口服维生素D3可提高前列腺骨化三醇水平（1级证据），并适度降低PSA和PTH。虽然Ki67表达在各剂量组之间无差异，但其水平与前列腺骨化三醇呈负相关。这些临床获益的迹象为继续开展临床研究提供了依据。
