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一项双盲、安慰剂对照随机试验,评估富含多酚的全食物补充剂对前列腺癌男性患者前列腺特异性抗原(PSA)进展的影响——英国国家癌症研究网络(NCRN)的Pomi-T研究。

A double-blind, placebo-controlled randomised trial evaluating the effect of a polyphenol-rich whole food supplement on PSA progression in men with prostate cancer--the U.K. NCRN Pomi-T study.

作者信息

Thomas R, Williams M, Sharma H, Chaudry A, Bellamy P

机构信息

1] The Primrose Research Unit, Bedford Hospital, Bedford, UK [2] Department of Oncology, Addenbrooke's Cambridge University NHS Trust, Cambridge, UK [3] Department of Postgraduate Medicine, Cranfield University, Cranfield, UK.

The Primrose Research Unit, Bedford Hospital, Bedford, UK.

出版信息

Prostate Cancer Prostatic Dis. 2014 Jun;17(2):180-6. doi: 10.1038/pcan.2014.6. Epub 2014 Mar 11.

Abstract

BACKGROUND

Polyphenol-rich foods such as pomegranate, green tea, broccoli and turmeric have demonstrated anti-neoplastic effects in laboratory models involving angiogenesis, apoptosis and proliferation. Although some have been investigated in small, phase II studies, this combination has never been evaluated within an adequately powered randomised controlled trial.

METHODS

In total, 199 men, average age 74 years, with localised prostate cancer, 60% managed with primary active surveillance (AS) or 40% with watchful waiting (WW) following previous interventions, were randomised (2:1) to receive an oral capsule containing a blend of pomegranate, green tea, broccoli and turmeric, or an identical placebo for 6 months.

RESULTS

The median rise in PSA in the food supplement group (FSG) was 14.7% (95% confidence intervals (CIs) 3.4-36.7%), as opposed to 78.5% in the placebo group (PG) (95% CI 48.1-115.5%), difference 63.8% (P=0.0008). In all, 8.2% of men in the FSG and 27.7% in the PG opted to leave surveillance at the end of the intervention (χ2 P=0.014). There were no significant differences within the predetermined subgroups of age, Gleason grade, treatment category or body mass index. There were no differences in cholesterol, blood pressure, blood sugar, C-reactive protein or adverse events.

CONCLUSIONS

This study found a significant short-term, favourable effect on the percentage rise in PSA in men managed with AS and WW following ingestion of this well-tolerated, specific blend of concentrated foods. Its influence on decision-making suggests that this intervention is clinically meaningful, but further trials will evaluate longer term clinical effects, and other makers of disease progression.

摘要

背景

富含多酚的食物,如石榴、绿茶、西兰花和姜黄,在涉及血管生成、细胞凋亡和增殖的实验室模型中已显示出抗肿瘤作用。尽管其中一些已在小型II期研究中进行了调查,但这种组合从未在有足够样本量的随机对照试验中进行评估。

方法

总共199名平均年龄74岁的局部前列腺癌男性患者,其中60%在先前干预后接受了主动监测(AS)或40%接受了观察等待(WW),被随机分为两组(2:1),分别接受含有石榴、绿茶、西兰花和姜黄混合物的口服胶囊或相同的安慰剂,为期6个月。

结果

食品补充剂组(FSG)的前列腺特异性抗原(PSA)中位数上升14.7%(95%置信区间(CI)3.4 - 36.7%),而安慰剂组(PG)为78.5%(95%CI 48.1 - 115.5%),差异为63.8%(P = 0.0008)。总体而言,FSG组8.2%的男性和PG组27.7%的男性在干预结束时选择退出监测(χ2检验P = 0.014)。在年龄、 Gleason分级、治疗类别或体重指数的预定亚组中没有显著差异。胆固醇、血压、血糖、C反应蛋白或不良事件方面也没有差异。

结论

本研究发现,对于接受AS和WW管理的男性,摄入这种耐受性良好的特定浓缩食物混合物后,PSA上升百分比有显著的短期有利影响。其对决策的影响表明该干预具有临床意义,但进一步的试验将评估长期临床效果以及疾病进展的其他指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c630/4020278/b01cc1a636e8/pcan20146f1.jpg

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