Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Prostate Cancer Prostatic Dis. 2021 Sep;24(3):725-732. doi: 10.1038/s41391-020-00317-w. Epub 2021 Jan 25.
Androgen deprivation therapy (ADT) for prostate cancer (PC) has detrimental effects on physical function and quality of life (QoL), but the addition of androgen receptor signalling inhibitors (ARSI) on these outcomes is unclear.
To compare body composition, physical function, and QoL across progressive stages of PC and non-cancer controls (CON).
In men with hormone sensitive PC (HSPC, n = 43) or metastatic castration-resistant PC (mCRPC, n = 22) or CON (n = 37), relative and absolute lean and fat mass, physical function (6 m walk, chair stands, timed up and go [TUG], stair climb), and QoL were determined.
Relative body composition differed amongst all groups, along with ~39% greater absolute fat mass in mCRPC vs. CON. TUG and chair stands were ~71% and ~33% slower in mCRPC compared to both CON and HSPC, whereas stair climb was ~29% and 6 m walk was ~18% slower in mCRPC vs. CON. Relative body composition was correlated with physical function (r = 0.259-0.385). Clinically relevant differences for mCRPC were observed for overall QoL and several subscales vs. CON, although body composition and physical function did not influence QoL.
PC progression is associated with deteriorations in body composition and physical function. As ADT length was similar between groups, ARSI use for mCRPC likely contributed in part to these changes. Given the difficulties of improving lean mass during ADT, interventions that reduce adiposity may lessen the side effects of hormone therapy.
前列腺癌（PC）的雄激素剥夺疗法（ADT）对身体功能和生活质量（QoL）有不利影响，但添加雄激素受体信号抑制剂（ARSI）对这些结果的影响尚不清楚。
比较进展性 PC 患者和非癌症对照（CON）之间的身体成分、身体功能和 QoL。
在患有激素敏感型 PC（HSPC，n=43）或转移性去势抵抗性 PC（mCRPC，n=22）或 CON（n=37）的男性中，确定相对和绝对瘦体重和脂肪量、身体功能（6 米步行、椅子站立、计时起立和行走 [TUG]、爬楼梯）和 QoL。
所有组之间的相对身体成分不同，并且 mCRPC 与 CON 相比，绝对脂肪量增加了约 39%。与 CON 和 HSPC 相比，mCRPC 的 TUG 和椅子站立速度分别慢了约 71%和 33%，而 mCRPC 的爬楼梯速度比 CON 慢了约 29%，6 米步行速度比 CON 慢了约 18%。相对身体成分与身体功能相关（r=0.259-0.385）。与 CON 相比，mCRPC 的整体 QoL 和几个亚量表存在临床相关差异，尽管身体成分和身体功能并未影响 QoL。
PC 的进展与身体成分和身体功能的恶化有关。由于各组之间的 ADT 长度相似，因此 mCRPC 中 ARSI 的使用可能部分导致了这些变化。鉴于在 ADT 期间改善瘦体重存在困难，减少脂肪量的干预措施可能会减轻激素治疗的副作用。
