Shahvazi Simin, Soltani Sepideh, Ahmadi Seyed Mehdi, de Souza Russell J, Salehi-Abargouei Amin
Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Department of Nutrition, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Horm Metab Res. 2019 Jan;51(1):11-21. doi: 10.1055/a-0774-8809. Epub 2018 Dec 6.
Vitamin D has received attention for its potential to disrupt cancer processes. However, its effect in the treatment of prostate cancer is controversial. This study aimed to assess the effect of vitamin D supplementation on patients with prostate cancer. In the present study, PubMed, Scopus, ISI Web of Science, and Google Scholar were searched up to September 2017 for trials that evaluated the effect of vitamin D supplementation on prostate specific antigen (PSA) response, mortality, and its possible side effects in participants with prostate cancer. The DerSimonian and Laird inverse-weighted random-effects model was used to pool the effect estimates. Twenty-two studies (16 before-after and 6 randomized controlled trials) were found and included in the meta-analysis. The analysis of controlled clinical trials revealed that PSA change from baseline [weighted mean difference (WMD)=-1.66 ng/ml, 95% CI: -0.69, 0.36, p=0.543)], PSA response proportion (RP=1.18, 95% CI: 0.97, 1.45, p=0.104) and mortality rate (risk ratio (RR)=1.05, 95% CI: 0.81-1.36; p=0.713) were not significantly different between vitamin D supplementation and placebo groups. Single arm trials revealed that vitamin D supplementation had a modest effect on PSA response proportion: 19% of those enrolled had at least a 50% reduction in PSA by the end of treatment (95% CI: 7% to 31%; p=0.002). Although before-after studies showed that vitamin D increases the PSA response proportion, it does not seem that patients with prostate cancer benefit from high dose vitamin D supplementation and it should not be recommended for the treatment.
维生素D因其在干扰癌症进程方面的潜力而受到关注。然而，其在前列腺癌治疗中的效果存在争议。本研究旨在评估补充维生素D对前列腺癌患者的影响。在本研究中，检索了截至2017年9月的PubMed、Scopus、ISI科学网和谷歌学术，以查找评估补充维生素D对前列腺癌患者前列腺特异性抗原（PSA）反应、死亡率及其可能的副作用的试验。采用DerSimonian和Laird逆加权随机效应模型汇总效应估计值。共发现22项研究（16项前后对照研究和6项随机对照试验）并纳入荟萃分析。对照临床试验分析显示，补充维生素D组和安慰剂组之间的PSA自基线的变化[加权平均差（WMD）=-1.66 ng/ml，95%置信区间：-0.69，0.36，p=0.543]、PSA反应比例（RP=1.18，95%置信区间：0.97，1.45，p=0.104）和死亡率（风险比（RR）=1.05，95%置信区间：0.81 - 1.36；p=0.713）无显著差异。单臂试验显示，补充维生素D对PSA反应比例有适度影响：19%的入组患者在治疗结束时PSA至少降低50%（95%置信区间：7%至31%；p=0.002）。尽管前后对照研究表明维生素D可提高PSA反应比例，但前列腺癌患者似乎无法从高剂量补充维生素D中获益，因此不建议将其用于治疗。
