Nishiyama Tsutomu, Ishizaki Fumio, Anraku Tsutomu, Shimura Hisanobu, Takahashi Kota
Division of Urology, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Asahimachi 1-757, Niigata 951-8510, Japan.
J Clin Endocrinol Metab. 2005 Feb;90(2):657-60. doi: 10.1210/jc.2004-1611. Epub 2004 Nov 23.
The effects of androgen deprivation therapy (ADT) include not only suppression of tumor growth, but also adverse effects on various bodily functions. The aim of this study was to determine the metabolic effects of ADT in patients with nonmetastatic prostate cancer. Forty-nine men with prostate cancer were treated with ADT before beginning radical therapy for 6 months. Body weight, peripheral red blood cell counts, hemoglobin, hematocrit, fasting blood sugar, serum total cholesterol, blood urea nitrogen, uric acid, compensated calcium, inorganic phosphorus, bone-specific alkaline phosphatase, urinary deoxypyridinoline, and radial bone density determined using dual energy x-ray absorptiometry were examined before and 6 months after ADT treatment. Body weight (P = 0.037) and the levels of fasting blood sugar (P = 0.014), serum total cholesterol (P = 0.017), blood urea nitrogen (P = 0.030), compensated calcium (P < 0.001), inorganic phosphorus (P < 0.001), bone-specific alkaline phosphatase (P < 0.001), and compensated urinary deoxypyridinoline (P < 0.001) increased significantly. Peripheral red blood cell counts (P < 0.001), hemoglobin level (P < 0.001), hematocrit (P < 0.001), uric acid (P < 0.001), and radial bone density (P = 0.023) decreased significantly. These effects of ADT on various bodily functions warrant systematic study in clinical trials. We should be aware of the far-reaching consequences of ADT and incorporate strategies for preventing and managing adverse effects into routine practice.
雄激素剥夺疗法(ADT)的作用不仅包括抑制肿瘤生长,还会对身体的各种功能产生不良影响。本研究的目的是确定ADT对非转移性前列腺癌患者的代谢影响。四十九名前列腺癌男性患者在开始根治性治疗前接受了6个月的ADT治疗。在ADT治疗前和治疗6个月后,检测了体重、外周红细胞计数、血红蛋白、血细胞比容、空腹血糖、血清总胆固醇、血尿素氮、尿酸、血钙、无机磷、骨特异性碱性磷酸酶、尿脱氧吡啶啉以及使用双能X线吸收法测定的桡骨骨密度。体重(P = 0.037)、空腹血糖水平(P = 0.014)、血清总胆固醇(P = 0.017)、血尿素氮(P = 0.030)、血钙(P < 0.001)、无机磷(P < 0.001)、骨特异性碱性磷酸酶(P < 0.001)和尿脱氧吡啶啉(P < 0.001)显著升高。外周红细胞计数(P < 0.001)、血红蛋白水平(P < 0.001)、血细胞比容(P < 0.001)、尿酸(P < 0.001)和桡骨骨密度(P = 0.023)显著降低。ADT对身体各种功能的这些影响值得在临床试验中进行系统研究。我们应该意识到ADT的深远后果,并将预防和管理不良反应的策略纳入常规实践。