Continuum Cancer Centers of New York, Beth Israel Medical Center and St Luke's-Roosevelt Hospital, New York, NY, USA.
J Clin Oncol. 2010 Dec 1;28(34):5054-60. doi: 10.1200/JCO.2010.30.3818. Epub 2010 Oct 25.
Symptoms secondary to hormonal changes significantly impact quality of life (QoL) in patients with cancer. This cross-sectional study examines prevalence of hypogonadism and its correlation with QoL and sexual dysfunction.
We collected blood and medical histories from 428 male patients with non-testosterone-related cancer at three cancer centers. Serum was analyzed for total testosterone (TT), free testosterone (FT), bioavailable testosterone (BAT), and sex hormone binding globulin (SHBG). The Functional Assessment of Cancer Therapy-Prostate (FACT-P) QoL questionnaire measured physical, social, emotional, and functional domains as well as sexual function. Exclusion criteria were prostate, testicular, or male breast cancer; known hypogonadism; and HIV.
Mean and median TTs were 337.46 and 310 ng/dL, respectively. The mean age of patients was 62.05 years. The crude prevalence of hypogonadism (ie, TT < 300 ng/dL) was 48%, and mean TT in hypogonadal patients was 176 ng/dL. The prevalences that were based on FT (ie, hypogonadal < 52 pg/dL) and BAT (ie, hypogonadal < 95 ng/dL) were 78% and 66%, respectively. The mean FT and BAT values in hypogonadal patients were 25 pg/dL and 45 ng/dL, respectively. Hypogonadal patients had decreased total QoL scores on FACT-P (P = .01) and decreased three-item sexual function subset (P = .003).
The prevalence of hypogonadism was unexpectedly high. Measurement of FT or BAT detected a higher prevalence than TT alone, which confirmed previous studies. Correlation of T with FACT-P showed significant reduction of both overall QoL and sexual function for hypogonadal men. BAT and FT levels showed a stronger correlation than TT with overall FACT-P and subscales. The prevalence of symptomatic hypogonadism in male patients with cancer exceeds that found in comparable studies in noncancer populations.
与激素变化相关的症状会显著影响癌症患者的生活质量（QoL）。本横断面研究调查了性腺功能减退症的患病率及其与 QoL 和性功能障碍的相关性。
我们从三家癌症中心的 428 名非睾酮相关癌症男性患者中收集了血液和病史。对血清总睾酮（TT）、游离睾酮（FT）、生物可利用睾酮（BAT）和性激素结合球蛋白（SHBG）进行了分析。功能评估癌症治疗前列腺（FACT-P）QoL 问卷测量了身体、社会、情感和功能领域以及性功能。排除标准为前列腺癌、睾丸癌或男性乳腺癌；已知性腺功能减退症；和艾滋病毒。
平均和中位数 TT 分别为 337.46 和 310ng/dL。患者的平均年龄为 62.05 岁。性腺功能减退症（即 TT <300ng/dL）的粗患病率为 48%，性腺功能减退症患者的平均 TT 为 176ng/dL。基于 FT（即，FT <52pg/dL）和 BAT（即，BAT <95ng/dL）的患病率分别为 78%和 66%。性腺功能减退症患者的平均 FT 和 BAT 值分别为 25pg/dL 和 45ng/dL。性腺功能减退症患者的 FACT-P 总 QoL 评分降低（P=.01），三项性功能亚组评分降低（P=.003）。
性腺功能减退症的患病率出人意料地高。FT 或 BAT 的测量比 TT 单独检测到更高的患病率，这证实了之前的研究。T 与 FACT-P 的相关性表明，性腺功能减退症男性的整体 QoL 和性功能均显著降低。BAT 和 FT 水平与总体 FACT-P 和子量表的相关性强于 TT。癌症男性患者中症状性性腺功能减退症的患病率高于非癌症人群中类似研究的患病率。
