Androgen deprivation therapy for the treatment of prostate cancer: consider both benefits and risks.
Androgen deprivation therapy for the treatment of prostate cancer: consider both benefits and risks.
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DOI：
10.1016/j.eururo.2008.10.008
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发表时间：
2009-01
期刊：
影响因子：
23.4
通讯作者：
Studer, Urs E.
中科院分区：
文献类型：
--
作者：
Isbarn, Hendrik;Boccon-Gibod, Laurent;Carroll, Peter R.;Montorsi, Francesco;Schulman, Claude;Smith, Matthew R.;Sternberg, Cora N.;Studer, Urs E.
雄激素剥夺疗法（ADT）越来越多地用于前列腺癌（PCa）的治疗，即使在没有证据证明延长总生存期（OS）的临床环境中也是如此。然而，ADT可能与许多副作用相关，包括与治疗相关的心血管死亡率增加。讨论目前使用ADT的不同临床环境，并严格权衡ADT的益处及其可能的副作用。在MEDLINE上进行了检索，以确定关于ADT治疗PCa的疗效和副作用的原始文章和综述文章。关键词：前列腺癌，激素治疗，不良反应，根治性前列腺切除术，放疗。在所有作者达成共识的情况下，确定了各种研究终点证据水平最高的文章，并对其进行了审查。即使短期使用ADT也可能导致许多副作用，如骨质疏松、肥胖、肌肉减少、脂质改变、胰岛素抵抗，以及增加糖尿病和心血管疾病的风险。尽管有这些副作用，ADT通常用于各种临床环境中，但尚未显示出对改善OS的明显效果。ADT与多种副作用的风险增加有关，这些副作用可能降低生活质量和/或OS。因此，在ADT开始前，这些问题应与患者及其家属详细讨论。在使用ADT时，应了解其潜在的长期副作用，并配合可能的生活方式干预，特别是在风险-收益比最高的情况下，以减轻合并症。
Androgen deprivation therapy (ADT) is increasingly used for the treatment of prostate cancer (PCa), even in clinical settings in which there is no evidence-based proof of prolonged overall survival (OS). ADT, however, may be associated with numerous side effects, including an increased therapy-related cardiovascular mortality. To discuss different clinical settings in which ADT is currently used and to critically weigh the benefits of ADT against its possible side effects. A MEDLINE search was conducted to identify original articles and review articles addressing the efficacy and side effects of ADT for the treatment of PCa. Keywords consisted of prostate cancer, hormonal therapy, adverse effects, radical prostatectomy, and radiotherapy. The articles with the highest level of evidence for the various examined end points were identified with the consensus of all authors and were reviewed. Even short-term use of ADT may lead to numerous side effects, such as osteoporosis, obesity, sarcopenia, lipid alterations, insulin resistance, and increased risk for diabetes and cardiovascular morbidity. Despite these side effects, ADT is commonly used in various clinical settings in which a clear effect on improved OS has not been shown. ADT is associated with an increased risk of multiple side effects that may reduce quality of life and/or OS. Consequently, these issues should be discussed in detail with patients and their families before initiation of ADT. ADT should be used with knowledge of its potential long-term side effects and with possible lifestyle interventions, especially in settings with the highest risk–benefit ratio, to alleviate comorbidities.
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影响因子：
16.2
作者：
通讯作者：
--
影响因子：
4.5
作者：
Boccon-Gibod, Laurent;Hammerer, Peter;Tunn, Ulf
通讯作者：
Tunn, Ulf
DOI：
10.1016/j.ijrobp.2004.08.024
发表时间：
2005-04-01
影响因子：
7
作者：
Beyer, DC;McKeough, T;Thomas, T
通讯作者：
Thomas, T
影响因子：
23.4
作者：
Efstathiou, Jason A.;Bae, Kyounghwa;Smith, Matthew R.
通讯作者：
Smith, Matthew R.
影响因子：
4.5
作者：
Barry, Michael J.;Delorenzo, Michael A.;Wennberg, David C.
通讯作者：
Wennberg, David C.