Does neoadjuvant hormone therapy for early prostate cancer affect cognition? Results from a pilot study
Does neoadjuvant hormone therapy for early prostate cancer affect cognition? Results from a pilot study
复制标题
DOI：
10.1111/j.1464-410x.2005.05565.x
复制
发表时间：
2005-07-01
影响因子：
4.5
通讯作者：
Edginton, TL
中科院分区：
文献类型：
--
作者：
Jenkins, VA;Bloomfield, DJ;Edginton, TL
在一项前瞻性研究中，为了检查局部前列腺癌的暂时可逆性药物去势对认知的影响，通过评估在根治性放疗前用促黄体生成激素释放激素（LHRH）激动剂暂时治疗3-5个月是否对认知功能有短期或长期影响。两名局限性前列腺癌患者在药物治疗开始前的基线（T1）、在3个月（T2）或完成药物治疗但在放疗前以及9个月后（T3）进行认知评估。18名没有前列腺癌的男性（对照组）在同一时间完成了认知测试。此外，同时评估心理功能和生活质量，以及血清游离和结合睾酮、β-雌二醇和性激素结合球蛋白水平。T2时，15例（47%）患者与3例（17%）对照组有显著的认知能力下降（至少一项认知任务）（优势比4.412，P = 0.033）。大多数患者（15人中有9人）在空间记忆和能力任务上表现有所下降。在T3有显着的认知能力下降，11（34%）患者和5（28%）对照组（比值比1.37，P = 0.631）。CONCLUSIONThis试点研究表明，短期LHRH治疗早期前列腺癌有适度的短期后果对男性的认知功能，一个更大的前瞻性研究是必要的。
OBJECTIVETo examine, in a prospective study, the influence that temporary reversible medical castration for localized prostate cancer has on cognition, by assessing whether temporary 3-5 month treatment with a luteinizing-hormone releasing hormone (LHRH) agonist before radical radiotherapy had a short- or long-term affect on cognitive function.PATIENTS AND SUBJECTS AND METHODSThirty-two patients with localized prostate cancer had cognitive assessments at baseline (T1) before the start of drug treatment, at 3 months (T2) or on completing drug treatment but before radiotherapy, and 9 months later (T3). Eighteen men with no prostate cancer (controls subjects) completed the cognitive tests at the same times. In addition, psychological functioning and quality of life were assessed at the same times, together with serum free and bound testosterone, beta-oestradiol and sex hormone-binding globulin levels.RESULTSThere was a significant cognitive decline (on at least one cognitive task) at T2 in 15 (47%) patients vs three (17%) of controls (odds ratio 4.412, P = 0.033). Most patients (nine of 15) who had a change in performance declined on tasks of spatial memory and ability. At T3 there was significant cognitive decline in 11 (34%) patients and five (28%) control subjects (odds ratio 1.37, P = 0.631).CONCLUSIONThis pilot study suggests that short-term LHRH therapy for early-stage prostate cancer has modest short-term consequences on men's cognitive functioning; a larger prospective study is warranted.