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补充维生素D对前列腺癌的影响:随机对照试验的系统评价

Effect of Vitamin D Supplementation in Prostate Cancer: A Systematic Review of Randomized Control Trials.

作者信息

Petrou Spyros, Mamais Ioannis, Lavranos Giagkos, P Tzanetakou Irene, Chrysostomou Stavri

机构信息

1 Department of Life Sciences, European University Cyprus, Nicosia-Cyprus.

2 Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Greece.

出版信息

Int J Vitam Nutr Res. 2018 Feb;88(1-2):100-112. doi: 10.1024/0300-9831/a000494. Epub 2019 Apr 30.

Abstract

Vitamin D is important in many cellular functions including cell cycling and proliferation, differentiation, and apoptosis. Via the induction of cell cycle arrest and/or apoptosis, vitamin D inhibits normal prostatic epithelial cells growth. Review the evidence of the effect of vitamin D supplementation on prostate cancer (PC) biomarkers and patient survival and assess optimal dosage, formulation and duration. Pubmed, Medline and Ebsco Host databases were systematically searched for relevant literature. 8 Randomized Controlled Trials were included in this review. All studies, besides one, were of high methodological quality. 4 studies used calcitriol (0,5-45 μg/weekly), 2 studies have used vitamin D3 (150-1000 μg/daily) and 2 other studies have used 1α-hydroxy Vitamin D2 (10 μg/ daily or weekly). Duration of supplementation varied between 28 days up to 18.3 months. Two studies had positive effects on prostate specific antigen (PSA) (p < .05), 1 study had a significant positive effect on median survival (p < .05) and 1 study showed a significant reduction of vitamin D receptor (VDR) expression (p < .05). The remaining studies showed negative or no effect on PC characteristics, clinical outcomes and/or survival. Current evidence suggests that vitamin D supplementation in conjunction with standard of care (e.g. chemotherapy, radiation therapy) may confer clinical benefits such as a decrease in serum PSA levels and VDR expression but further research is required to ascertain these results. Calcitriol supplementation in doses ranging from 250-1000 mg for 3-8 weeks or a lower dose of 45 mg for 18.3 months, appear most beneficial regarding outcomes of PC progression and survival.

摘要

维生素D在许多细胞功能中都很重要,包括细胞周期和增殖、分化以及凋亡。通过诱导细胞周期停滞和/或凋亡,维生素D抑制正常前列腺上皮细胞的生长。回顾补充维生素D对前列腺癌(PC)生物标志物和患者生存率影响的证据,并评估最佳剂量、制剂和持续时间。系统检索了PubMed、Medline和Ebsco Host数据库中的相关文献。本综述纳入了8项随机对照试验。除一项研究外,所有研究的方法学质量都很高。4项研究使用了骨化三醇(0.5 - 45μg/周),2项研究使用了维生素D3(150 - 1000μg/天),另外2项研究使用了1α-羟基维生素D2(10μg/天或周)。补充的持续时间在28天至18.3个月之间。两项研究对前列腺特异性抗原(PSA)有积极影响(p < 0.05),一项研究对中位生存期有显著积极影响(p < 0.05),一项研究显示维生素D受体(VDR)表达显著降低(p < 0.05)。其余研究对PC特征、临床结局和/或生存率显示出负面或无影响。目前的证据表明,补充维生素D结合标准治疗(如化疗、放疗)可能带来临床益处,如血清PSA水平和VDR表达降低,但需要进一步研究来确定这些结果。补充骨化三醇,剂量为250 - 1000mg,持续3 - 8周,或较低剂量45mg,持续18.3个月,似乎对PC进展和生存结局最有益。

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