在前列腺癌退伍军人中,雄激素缺乏后不良事件的种族差异
Nadine A Friedrich1,2,3, Jessica L Janes4, Joshua Parrish4
1Department of Urology, Cedars-Sinai Medical Center, Los Angeles, California.
JAMA network open
|November 19, 2025
概括
抗雄激素剥夺疗法 (ADT) 在所有种族的前列腺癌患者中增加了心血管和骨风险. 虽然黑人和白人患者之间的风险略有不同,但监测对所有人来说都至关重要.
科学领域:
- 在瘤学瘤学.
- 心血管医学 心血管医学
- 骨健康 骨健康 骨健康
背景情况:
- 安卓素剥夺疗法 (ADT) 是一种常见的前列腺癌 (PC) 治疗方法.
- ADT与心脏问题和骨质疏松症等不良事件有关.
- 在ADT的不良事件关联中的种族差异尚未得到充分理解.
研究的目的:
- 评估ADT与心血管和骨相关不良事件之间的关联.
- 确定这些关联是否在PC患者的种族群体之间存在差异.
主要方法:
- 使用退伍军人事务医疗保健系统数据 (2001-2021) 进行了回顾性,全国性,基于人口的队列研究.
- 包括790,916名PC退伍军人,不包括特殊治疗组和缺少种族数据的退伍军人.
- 使用考克斯模型来评估ADT与时间到事件结果的关联,按种族分层.
主要成果:
- 在所有种族中,ADT显著增加了心血管事件 (HR 1.16),骨折 (HR 1.59) 和骨质疏松症 (HR 2.73) 的风险.
- 在黑人患者与白人患者之间,ADT显示心血管事件和骨折的风险略低,但骨质疏松症的风险更高.
- 西班牙裔患者和其他种族患者的风险关联与白人患者相似.
结论:
- 在所有种族的前列腺癌患者中,ADT与心血管和骨风险的增加有关.
- 虽然黑人和白人患者之间存在微小的差异,但整体风险关联是可比的.
- 强调需要对所有接受ADT的患者进行警监测和风险减轻策略.
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