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Chemoprevention of prostate cancer: is there evidence from clinical trials?

机译：化学预防前列腺癌：临床试验是否有证据？

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摘要

Prostate cancer is the most common malignancy in men and the second leading cause of death from cancer in Western society. Due to the introduction of prostate-specific antigen screening, insignificant tumors are being over-diagnosed and patients who may not benefit from curative procedures (i.e., surgery or radiotherapy) are being overtreated, and resultantly may suffer the consequences of these procedures, leading to decreased quality of life. Thus, prostate cancer prevention could result in saving lives and, even if this goal cannot be achieved, reduction of morbidity and economic gains are significant end points that may be reached. Many compounds have been hypothesized as possible chemoprevention agents in epidemiological or observational studies. However, there are few clinical trials available in the current literature. This article reviews the main clinical trials that have been published regarding prostate cancer chemoprevention. Pharmacological intervention is discussed through papers suggesting that 5a-reductase inhibitors, such as dutasteride and finasteride, may prevent prostate cancer. Toremifen and statins are also possible chemoprevention agents. Dietary supplementation with selenium, vitamins A, C, D and E, folic acid, green tea, soy and lycopene are also debated.
机译：前列腺癌是男性最常见的恶性肿瘤，也是西方社会死于癌症的第二大主要原因。由于前列腺特异性抗原筛查的引入，对微小肿瘤的诊断过度，可能无法从治愈性手术（即外科手术或放射疗法）中受益的患者受到过度治疗，结果可能遭受这些程序的后果，从而导致生活质量下降。因此，预防前列腺癌可以挽救生命，即使无法实现这一目标，发病率的降低和经济收益的提高也是可以达到的重要终点。在流行病学或观察研究中，许多化合物被认为是可能的化学预防剂。但是，当前文献中很少有临床试验可用。本文回顾了已发表的有关前列腺癌化学预防的主要临床试验。通过论文讨论了药物干预，这些研究表明5a-还原酶抑制剂（例如度他雄胺和非那雄胺）可以预防前列腺癌。托瑞芬和他汀类药物也可能是化学预防剂。饮食中硒，维生素A，C，D和E，叶酸，绿茶，大豆和番茄红素的补充也受到争议。

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