在前列腺癌患者中延迟丸激素恢复的影响
Mark A Preston1, Agnes Hong2, Robert Dufour3
1Brigham and Women's Hospital, Boston, MA, USA.
European urology open science
|February 1, 2024
概括
在雄激素剥夺疗法 (ADT) 后前列腺癌患者的丸激素恢复延迟与糖尿病和抑郁症风险增加有关. 在ADT后监测丸激素水平对于这些患者的长期健康管理至关重要.
科学领域:
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 医学上,雄激素剥夺疗法 (ADT) 是前列腺癌的基石治疗.
- 在停止使用ADT后,丸激素 (TR) 恢复延迟是一个公认的临床问题.
- 低于最佳的TR的长期健康影响仍然不完全理解.
研究的目的:
- 在前列腺癌患者中,在停止医学雄激素剥夺疗法 (ADT) 后,评估延迟丸激素恢复 (TR) 的临床影响.
- 确定TR状态和新出现的并发症的发展之间的关联.
- 为临床实践提供有关ADT后监测的信息.
主要方法:
- 用非识别的电子健康记录数据 (2010-2021) 对患有前列腺癌的成年男性进行了回顾性纵向分析.
- 纳入标准:已开始和停止的ADT,在停止治疗后的12个月内至少进行一次水平测试.
- 队列:TR (>280 ng/dL在12个月内) 与非TR. 根据基线特征进行调整.
主要成果:
- 在1553名符合标准的患者中,25%实现了TR,75%没有.
- 在TR队列中,新发糖尿病的风险显著降低 (HR 0.47;95% CI 0.27-0.79).
- TR队列趋向于较低的新发抑郁风险 (HR 0.58;95% CI 0.33-1.02) 和更高的寻求治疗性功能障碍的可能性 (HR 1.33;95% CI 0.99-1.78).
结论:
- 停用ADT后丸激素恢复的延迟与新发糖尿病和潜在的抑郁症风险的增加有关.
- 在前列腺癌患者的并发症主动管理中,对ADT后的丸激素水平的监测至关重要.
- 这些发现支持优化临床决策对患者进行ADT停止.
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