前列腺癌雄激素剥夺治疗期间潮热干扰的病程及调节因素：一项配对比较研究
Course and Moderators of Hot Flash Interference during Androgen Deprivation Therapy for Prostate Cancer: A Matched Comparison.
作者信息
Gonzalez Brian D, Jim Heather S L, Donovan Kristine A, Small Brent J, Sutton Steve K, Park Jong, Lin Hui-Yi, Spiess Philippe E, Fishman Mayer N, Jacobsen Paul B
机构信息
Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, Florida; Supportive Care Medicine, Moffitt Cancer Center, Tampa, Florida; Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, Florida; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, Florida; School of Aging Studies, University of South Florida, Tampa, Florida.
Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, Florida; Supportive Care Medicine, Moffitt Cancer Center, Tampa, Florida; Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, Florida; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, Florida; School of Aging Studies, University of South Florida, Tampa, Florida.
出版信息
J Urol. 2015 Sep;194(3):690-5. doi: 10.1016/j.juro.2015.03.026. Epub 2015 Mar 16.
PURPOSE
Many men receiving androgen deprivation therapy for prostate cancer experience hot flashes. This study aimed to describe the course of hot flash interference with time in androgen deprivation therapy recipients relative to matched prostate cancer and cancer-free controls from before the start of androgen deprivation therapy to 12 months later. We also examined demographic, clinical and genetic predictors of the impact of androgen deprivation therapy on hot flash interference.
MATERIALS AND METHODS
Three groups were examined, including 60 patients with prostate cancer recruited before or within 21 days of starting androgen deprivation therapy, 83 age and education matched patients with prostate cancer treated with prostatectomy only, and 86 age and education matched men with no history of cancer. Participants provided blood samples and completed the Hot Flash Related Daily Interference Scale at baseline as well as 6 and 12 months later.
RESULTS
Androgen deprivation therapy recipients reported increasing hot flash interference with time relative to controls (p <0.001). Group differences were evident at 6 and 12 months (all p <0.001) with androgen deprivation therapy recipients reporting greater hot flash interference than controls. Several genetic polymorphisms were found to predict greater increases in hot flash interference (all p <0.01), including polymorphisms on genes associated with vasoconstriction, immune function, neurotransmission and circadian rhythms. Androgen deprivation therapy recipients who were younger and had a lower body mass index at baseline also showed greater increases in hot flash interference with time (all p ≤0.01).
CONCLUSIONS
This study, which is to our knowledge the first to prospectively examine hot flash interference in androgen deprivation therapy recipients, reveals that those with certain genetic polymorphisms, younger age and lower body mass index had greater increases in hot flash interference with time relative to controls.
目的
许多接受雄激素剥夺治疗的前列腺癌男性会经历潮热。本研究旨在描述从雄激素剥夺治疗开始前到12个月后，相对于匹配的前列腺癌患者和无癌对照，雄激素剥夺治疗患者潮热干扰随时间的变化过程。我们还研究了雄激素剥夺治疗对潮热干扰影响的人口统计学、临床和遗传预测因素。
材料与方法
研究了三组人群，包括60例在开始雄激素剥夺治疗前或治疗开始后21天内招募的前列腺癌患者、83例年龄和教育程度匹配的仅接受前列腺切除术治疗的前列腺癌患者，以及86例年龄和教育程度匹配且无癌症病史的男性。参与者在基线时以及6个月和12个月后提供血样并完成潮热相关日常干扰量表。
结果
与对照组相比，雄激素剥夺治疗患者报告潮热干扰随时间增加（p<0.001）。在6个月和12个月时组间差异明显（所有p<0.001），雄激素剥夺治疗患者报告的潮热干扰比对照组更大。发现几种基因多态性可预测潮热干扰的更大增加（所有p<0.01），包括与血管收缩、免疫功能、神经传递和昼夜节律相关基因的多态性。基线时年龄较小且体重指数较低的雄激素剥夺治疗患者潮热干扰随时间的增加也更大（所有p≤0.01）。
结论
据我们所知，本研究是首次前瞻性研究雄激素剥夺治疗患者的潮热干扰，结果显示与对照组相比，具有某些基因多态性、年龄较小和体重指数较低的患者潮热干扰随时间增加更大。
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