The fat body mass increase after adjuvant androgen deprivation therapy is predictive of prostate cancer outcome
The fat body mass increase after adjuvant androgen deprivation therapy is predictive of prostate cancer outcome
复制标题
DOI：
10.1007/s12020-015-0525-x
复制
发表时间：
2015-09-01
期刊：
影响因子：
3.7
通讯作者：
Berruti, Alfredo
中科院分区：
文献类型：
--
作者：
Buttigliero, Consuelo;Vana, Federica;Berruti, Alfredo
雄激素剥夺疗法（ADT）导致身体组成的重要变化。目前没有关于这些治疗相关变化与患者结局之间关系的数据。使用双能X线吸收测定法，在基线时以及1年和2年后测定53例接受ADT辅助治疗的非转移性前列腺癌（PC）高危患者的骨矿物质密度（BMD）、脂肪体重（FBM）和瘦体重（LBM）。这些参数的变化与患者的不良骨骼事件、疾病复发和总生存率相关。ADT导致BMD（p < 0.03）和LBM（p < 0.03）显著降低，FBM增加（p < 0.0001）。骨密度的变化未显示出与发生泌尿系统相关事件（SRE）、疾病复发和死亡的时间有任何关系。FBM增加是SRE风险增加的显著预测因子[风险比（HR）3.024，95%CI 1.004-10.353，p < 0.02]，死亡风险增加（HR 2.373，95% CI 1.012-5.567，p = 0.04），疾病复发风险无显著性升高（HR 2.219，95% CI 0.956-5.150，p = 0.13）。LBM降低与SRE时间或生存期无关，而与疾病复发无显著相关性（HR 1.550，95% CI 0.670-3.605，p = 0.06）。FBM的早期增加可能为接受ADT治疗的PC患者提供不良结局的预测信息。这些数据表明，采取旨在减少脂肪增加的早期预防措施可能会降低发病率和死亡率风险。
Androgen deprivation therapy (ADT) leads to important changes in body composition. No data are currently available about the relationship between these treatment-related changes and patient outcome. Using dual-energy X-ray absorptiometry, bone mineral density (BMD), fat body mass (FBM), and lean body mass (LBM) were determined at baseline, and after 1 and 2 years in 53 non-metastatic prostate cancer (PC) patients with high-risk disease treated with adjuvant ADT. Changes in these parameters were correlated with patient outcome in terms of adverse skeletal events, disease recurrence, and overall survival. ADT led to a significant decrease in BMD (p < 0.03) and LBM (p < 0.03), and an increase in FBM, (p < 0.0001). Changes in BMD failed to show any relationship with time to skeletal-related events (SRE), disease recurrence, and death. FBM increase was a significant predictor of higher risk of SRE [hazard ratio (HR) 3.024, 95 % CI 1.004-10.353, p < 0.02], higher risk of death (HR 2.373, 95 % CI 1.012-5.567, p = 0.04), and a non-significant higher risk of disease recurrence (HR 2.219, 95 % CI 0.956-5.150, p = 0.13). LBM decrease did not correlate with either time to SRE or survival, while a non-significant association with disease recurrence (HR 1.550, 95 % CI 0.670-3.605, p = 0.06) was observed. The early increase in FBM may provide predictive information of poor outcome in PC patients given ADT. These data suggest that the adoption of early preventive measures aiming to reduce fat increase can potentially reduce the morbidity and mortality risk.