Chemoprevention of Primary Liver Cancer: A Randomized, Double-Blind Trial in Linxian, China

作者：Chuang Qu, Farin Kamangar, Jin‐Hu Fan, Binbing Yu, X.-D. Sun, Philip R. Taylor, Bingshu E. Chen, Christian C. Abnet, You‐Lin Qiao, Steven D. Mark, Sanford M. Dawsey · 发表于：JNCI Journal of the National Cancer Institute · 年份：2007 · DOI：10.1093/jnci/djm084 · 被引用次数：32 · 研究领域：Antioxidant Activity and Oxidative Stress、Retinoids in leukemia and cellular processes、Hepatocellular Carcinoma Treatment and Prognosis

BACKGROUND: Primary liver cancer is a common malignancy with a dismal prognosis. New primary prevention strategies are needed to reduce mortality from this disease. We examined the effects of supplementation with four different combinations of vitamins and minerals on primary liver cancer mortality among 29450 initially healthy adults from Linxian, China. METHODS: Participants were randomly assigned to take either a vitamin-mineral combination ("factor") or a placebo daily for 5.25 years (March 1986-May 1991). Four factors (at doses one to two times the US Recommended Daily Allowance)-retinol and zinc (factor A); riboflavin and niacin (factor B); ascorbic acid and molybdenum (factor C); and beta-carotene, alpha-tocopherol, and selenium (factor D)-were tested in a partial factorial design. The study outcome was primary liver cancer death occurring from 1986 through 2001. Adjusted Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of liver cancer death with and without each factor. All P values are two-sided. RESULTS: A total of 151 liver cancer deaths occurred during the analysis period. No statistically significant differences in liver cancer mortality were found comparing the presence and absence of any of the four intervention factors. However, both factor A and factor B reduced liver cancer mortality in individuals younger than 55 years at randomization (HR = 0.59, 95% CI = 0.34 to 1.00, and HR = 0.54, 95% CI = 0.3...