The effect of androgen deprivation therapy on body composition in men with prostate cancer: Systematic review and meta-analysis
The effect of androgen deprivation therapy on body composition in men with prostate cancer: Systematic review and meta-analysis
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DOI：
10.1007/s11764-009-0114-1
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发表时间：
2010-06-01
影响因子：
3.7
通讯作者：
Cantwell, Marie M.
中科院分区：
文献类型：
--
作者：
Haseen, Farhana;Murray, Liam J.;Cantwell, Marie M.
介绍在前列腺癌治疗中使用雄激素剥夺疗法（ADT）与身体组成的变化相关，包括脂肪增加和瘦体重减少。关于这些变化的速度和程度的信息有限。本系统评价进行，以确定ADT对前列腺癌patients.Methods的身体组成的影响进行文献检索MEDLINE，EMBASE和Web的科学研究，直到2009年1月。仅纳入了检查前列腺癌患者ADT和身体组成的纵向研究。结果16项研究（14个队列，2项随机对照试验）符合纳入标准。根据随机效应模型计算的汇总数据显示，ADT平均增加体脂百分比7.7%（95% CI 4.3，11.2，来自7项研究，P < 0.0001），瘦体重平均降低2.8%（95% CI-3.6，-2.0，6项研究，P < 0.0001），但两项研究之间存在显著异质性（分别为I2= 99%和I2= 73%）。同样，体重（2.1%，P < 0.0001，来自9项研究）和BMI（2.2%，P < 0.0001，来自8项研究）显著增加。更广泛的变化，看到了较长的持续时间treatment.Conclusions脂肪的大幅增加和瘦体重下降，观察前列腺癌患者用ADT治疗。需要研究生活方式的改变或适当的干预措施，以尽量减少ADT对身体组成的影响。对癌症幸存者的影响前列腺癌幸存者应该意识到治疗对身体成分的副作用，需要进一步的工作来确定什么样的干预措施可以最大限度地减少ADT对身体成分的影响，因此应该为他们提供什么样的循证建议。一般来说，虽然建议健康饮食和适度运动是合理的。
Introduction The use of androgen deprivation therapy (ADT) in the treatment of prostate cancer is associated with changes in body composition including increased fat and decreased lean mass. Limited information exists regarding the rate and extent of these changes. This systematic review was conducted to determine the effects of ADT on body composition in prostate cancer patients.Methods Literature searches were conducted on MEDLINE, EMBASE and Web of Science for studies until January 2009. Only longitudinal studies that examined ADT and body composition in prostate cancer patients were included. Data were extracted on body weight, BMI, percentage of fat mass and lean body mass.Results Sixteen studies (14 cohorts and 2 RCTs) met the inclusion criteria. Pooled data, calculated according to a random effects model, showed that ADT increased % body fat by on average 7.7% (95% CI 4.3, 11.2, from seven studies, P < 0.0001) and decreased % lean body mass by on average -2.8% (95% CI -3.6, -2.0, from six studies, P < 0.0001) but for both there was marked heterogeneity between studies (I2= 99% I2= 73%, respectively). Similarly, body weight (2.1%, P < 0.0001 from nine studies) and BMI (2.2%, P < 0.0001, from eight studies) increased significantly. More extensive changes were seen with longer duration of treatment.Conclusions Substantial increases in fat and declines in lean mass were observed in prostate cancer patients treated with ADT. Lifestyle changes or suitable interventions to minimize the effect of ADT on body composition need to be investigated. Implications for cancer survivors Prostate cancer survivors should be made aware of the side effect of treatment on body composition and further work is required to determine what interventions can minimize the impact of ADT on body composition and therefore what evidence based advice they should be provided with. In general, though recommendation of a healthy diet and moderate exercise is reasonable.