背景:多年来,人们普遍寻求有效的饮食模式和天然提取物来减轻前列腺癌的风险。然而,尽管对各种天然提取物进行了大量实验研究,证实其疗效的证据在很大程度上仍然不足。缺乏令人信服的证据对倡导将其广泛用作前列腺癌的预防措施提出了重大挑战。
目的:我们的研究致力于进行网络荟萃分析,以评估天然提取物对前列腺癌的影响。
方法:研究人员系统地搜索了Embase,PubMed,科克伦图书馆,和WebofScience数据库,直到2023年12月。主要重点是评估主要结局,包括前列腺特异性抗原(PSA),胰岛素样生长因子结合蛋白-3(IGFBP-3),胰岛素样生长因子-1(IGF-1)。采用StataMP15.0软件进行数据分析。基于从累积排序曲线下的表面(SUCRA)得出的概率值对治疗效果进行排序。此外,采用聚类分析评估天然提取物对三种不同结果的影响.
结果:按照筛查程序,纳入了28项符合条件的研究,选定的研究包括1,566名前列腺癌患者,并评估了16种不同的天然提取物治疗方法。具体来说,24项试验包括PSA指标,包括10个IGF-1指标,8个包含IGFBP-3指标。调查结果显示,基于SUCRA值,水飞蓟宾与硒的联合治疗(74%)似乎是降低血清PSA水平的最有效方法。同时,水飞蓟宾单独(84.6%)是降低血清IGF-1水平的最有希望的选择。最后,关于IGFBP-3,水飞蓟宾单独(67.7%)是最佳选择。12项研究提供了有关药物不良反应/事件(ADR/ADE)的全面信息。而五篇文章没有报告任何显著的ADR/ADE。
结论:NMA建议,与安慰剂相比,利用水飞蓟宾单独或与硒的组合已被证明可以增强治疗效果,为前列腺癌患者提供潜在的益处。这项研究可以为考虑天然提取物治疗的前列腺患者提供有价值的见解。需要进一步的证据来确认这些治疗的安全性。
BACKGROUND: Over years, there has been a widespread quest for effective dietary patterns and natural extracts to mitigate prostate cancer risk. However, despite numerous experimental studies conducted on various natural extracts, the evidence substantiating their efficacy remains largely insufficient. This dearth of compelling evidence presents a significant challenge in advocating for their widespread use as preventive measures against prostate cancer.
OBJECTIVE: Our study endeavors to undertake a network meta-analysis to evaluate the influence of natural extracts on prostate cancer.
METHODS: Researchers systematically searched through Embase, PubMed, Cochrane Library, and Web of Science databases until December 2023. The main focus was on assessing primary outcomes comprising prostate-specific antigen (PSA), insulin-like growth factor-binding protein-3 (IGFBP-3), insulin-like growth factor-1 (IGF-1). We conducted data analysis utilizing StataMP 15.0 software. Therapeutic effects were ranked based on the probability values derived from Surface Under the Cumulative Ranking curve (SUCRA). Additionally, cluster analysis was employed to assess the impacts of natural extracts on three distinct outcomes.
RESULTS: Following screening procedures, the 28 eligible studies were incorporated, the selected studies encompassed 1,566 prostate cancer patients and evaluated 16 different natural extract treatments. Specifically, 24 trials included PSA indicators, 10 included IGF-1 indicators, and 8 included IGFBP-3 indicators. The findings revealed that, based on the SUCRA values, the combined therapy of silybin with selenium (74%) appears to be the most effective approach for reducing serum PSA levels. Simultaneously, silybin alone (84.6%) stands out as the most promising option for decreasing serum IGF-1 levels. Lastly, concerning IGFBP-3, silybin alone (67.7%) emerges as the optimal choice. Twelve studies provided comprehensive information on adverse drug reactions/events (ADR/ADE), whereas five articles did not report any significant ADR/ADE.
CONCLUSIONS: The NMA suggests that, compared to placebo, utilizing silybin either alone or in combination with selenium has been shown to enhance therapeutic effects, offering potential benefits to patients with prostate cancer. This study can offer valuable insights for prostate patients considering natural extract treatments. Further evidence is required to confirm the safety profile of these treatments.