Division of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Sweden.
Maturitas. 2010 Jan;65(1):15-22. doi: 10.1016/j.maturitas.2009.10.017. Epub 2009 Dec 4.
The aim of this study was to describe hot flushes in men with prostate cancer, and their treatment methods.
A systematic review was conducted of the literature indexed between 1966 and 2009 on the MEDLINE, the ISI Web of Knowledge, Cinahl and PsycINFO. Of 252 articles identified, 32 were selected for consideration of their complete texts, of which five were subject to detailed analysis.
Diethylstilbestrol, megestrol acetate and cyproterone acetate have the strongest effect, giving a 75% or larger decrease of the number of hot flushes, but they may have severe or bothersome side-effects. Gabapentin has an uncertain effect. Clonidine is not proven effective for hot flushes. Long-term effects were not evaluated in any of the studies. SSRI/SNRI and acupuncture may have a moderate effect on hot flushes but are not proven in any RCTs.
Hot flushes are common and bothersome symptoms in men with prostate cancer and those taking anti-androgen treatment, and reduce quality of life. Few treatments are available and some are avoided for these patients. Additional prospective treatment studies are needed, with long-term follow-up, in order to evaluate the effects and risks of treatments. Treatments with few or no severe side-effects should be prioritised in future investigations. Experimental studies are also needed to elucidate the mechanism behind hot flushes in men and to suggest routes for the development of new treatments.
本研究旨在描述前列腺癌男性患者的热潮红症状及其治疗方法。
对 MEDLINE、ISI Web of Knowledge、Cinahl 和 PsycINFO 数据库中 1966 年至 2009 年间收录的文献进行了系统回顾。在检索到的 252 篇文章中，有 32 篇文章的全文被纳入考虑，其中 5 篇进行了详细分析。
己烯雌酚、甲地孕酮和环丙孕酮醋酸酯的效果最强，可使热潮红次数减少 75%或更多，但可能有严重或令人烦恼的副作用。加巴喷丁的效果不确定。可乐定对热潮红无效。在任何研究中都未评估长期效果。SSRIs/SNRIs 和针灸可能对热潮红有中度影响，但在任何 RCT 中都未得到证实。
热潮红是前列腺癌男性患者和接受抗雄激素治疗的患者常见且令人烦恼的症状，会降低生活质量。目前可选择的治疗方法有限，有些方法因这些患者的情况而被避免。需要开展更多有长期随访的前瞻性治疗研究，以评估治疗的效果和风险。在未来的研究中应优先考虑副作用少或无的治疗方法。还需要开展实验研究，以阐明男性热潮红的发生机制，并为开发新的治疗方法提供线索。
