Division of Urology, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
Can J Urol. 2020 Feb;27(27 Suppl 1):11-16.
Our objective is to provide an up-to-date summary of current literature on the indications for androgen deprivation therapy (ADT), ways in which ADT is used, and the main side effects associated with its use. MEDLINE (Pubmed) was searched for relevant papers published from database inception to May 1, 2019 for studies evaluating the use of ADT and its associated adverse events. ADT is a mainstay in the treatment of prostate cancer and is used throughout the disease course. While predominantly used in the metastatic setting, ADT has a role in the treatment of localized disease and in the management of recurrent cancer. Intermittent ADT has an application for a certain subset of men with recurrent and metastatic disease who have significant side effects. Associated side effects of ADT are wide ranging and include osteoporosis with an associated increased fracture risk, elevated rates of diabetes, metabolic syndrome, cardiovascular risk, sexual dysfunction and hot flashes. As ADT has a variety of associated side effects, care for men receiving ADT is best managed in a multidisciplinary setting with active participation between the treating physician (urologist, radiation oncologist) and their primary care physician.
我们的目标是提供当前关于雄激素剥夺疗法（ADT）适应证、ADT 应用方式以及与其使用相关的主要副作用的文献的最新总结。检索了 MEDLINE（PubMed），以获取截至 2019 年 5 月 1 日评估 ADT 使用及其相关不良事件的相关论文。ADT 是前列腺癌治疗的主要方法，贯穿于疾病全过程。虽然主要用于转移性疾病，但 ADT 在局部疾病的治疗和复发性癌症的管理中也有作用。间歇性 ADT 适用于某些复发性和转移性疾病的男性，这些男性有严重的副作用。ADT 的相关副作用范围广泛，包括骨质疏松症和相关的骨折风险增加、糖尿病、代谢综合征、心血管风险、性功能障碍和热潮红的发生率升高。由于 ADT 有多种相关的副作用，接受 ADT 治疗的男性最好在多学科环境中进行治疗，由治疗医生（泌尿科医生、放射肿瘤学家）和他们的初级保健医生共同参与。
