前列腺癌和神经认知障碍的雄激素剥夺疗法:系统性审查和元分析
David E Hinojosa-Gonzalez1, Affan Zafar2, Gal Saffati3
1Department of Urology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 1102, Boston, MA, 02114, USA. David.Hinojosa-Gonzalez@bcm.edu.
Prostate cancer and prostatic diseases
|January 3, 2024
概括
在前列腺癌患者中,雄激素剥夺疗法 (ADT) 显著增加了痴呆,阿尔茨海默病 (AD) 和帕金森病 (PD) 的风险. 这一发现突显了ADT治疗方案和患者监测的关键考虑因素.
科学领域:
- 在瘤学瘤学.
- 神经学 神经学
- 老年病的医生 老年病的医生
背景情况:
- 前列腺癌的治疗往往涉及雄激素缺乏疗法 (ADT).
- ADT与潜在的与治疗相关的并发症有关.
- 了解ADT与神经疾病之间的联系至关重要.
研究的目的:
- 系统地审查和分析关于ADT与痴呆症相关的证据.
- 在接受ADT的患者中调查阿尔茨海默病 (AD),血管痴呆症和帕金森病 (PD) 的风险.
- 综合当前关于ADT对认知和神经健康的影响的研究.
主要方法:
- 在主要数据库 (PubMed,EMBASE,Scopus,Google Scholar) 进行系统的文献搜索,截至2023年4月.
- 在选305个已识别的文章后,包括28项研究.
- 基于异质性评估 (I2%) 的随机效应或固定效应模型的元分析.
主要成果:
- 对27项研究中2,543,483名患者的分析.
- 对痴呆症 (1.20),AD (1.26),抑郁症 (1.66) 和PD (1.57) 观察到明显增加的危险比率 (HR).
- 发现了血管痴呆症风险增加的趋势 (HR 1.30).
结论:
- ADT与发展痴呆症,AD和PD的风险显著增加有关.
- 这些发现强调了监测ADT患者的神经健康的重要性.
- 进一步的研究可能会阐明机制,并为临床管理策略提供信息.
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