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雄激素剥夺疗法对转移性前列腺癌患者认知功能的影响:泌尿外科协会多中心前瞻性研究。

Effects of androgen deprivation therapy on cognitive functions in patients with metastatic prostate cancer: A multicentric, prospective study of the Society of Urological Surgery Andrology group.

机构信息

Department of Urology, Zonguldak Bulent Ecevit University, Zonguldak, Turkey.

Urology Clinic, Iskenderun Gelisim Hospital, Iskenderun, Turkey.

出版信息

Int J Clin Pract. 2021 Jun;75(6):e14095. doi: 10.1111/ijcp.14095. Epub 2021 Feb 28.

Abstract

AIMS OF THE STUDY

The aim of this study was to investigate the impact of testosterone deficiency on cognitive functions in metastatic prostate cancer patients receiving androgen deprivation therapy (ADT).

METHODS

In this multicentric prospective study, 65 metastatic prostate cancer patients were evaluated. Demographic and clinical data were recorded. Cognitive functions were assessed using the Symbol Digit Modalities Test, the California Verbal Learning Test Second Edition, the Brief Visuospatial Memory Test-Revised, and the Trail Making Test. Depressive symptoms were assessed using the Beck Depression Inventory. Cognitive functions and depressive symptoms were recorded before the androgen deprivation therapy and at the 3- and 6-month follow-ups.

RESULTS

At the basal cognitive assessment, the mean Symbol Digit Modalities Test, the California Verbal Learning Test Second Edition, the Brief Visuospatial Memory Test-Revised scores were 25.84 ± 17.54, 32.68 ± 10.60, and 17.63 ± 11.23, respectively, and the mean time for the Trail Making Test was 221.56 ± 92.44 seconds, and were similar at the 3-month, and 6-month controls (P > .05). The mean pretreatment, third and sixth month testosterone levels were 381.40 ± 157.53 ng/dL, 21.61 ± 9.09 ng/dL and 12.25 ± 6.45 ng/dL (P < .05), and the total PSA levels were 46.46 ± 37.83 ng/mL, 1.41 ± 3.31 ng/mL and 0.08 ± 0.14 ng/mL (P < .05), respectively.

CONCLUSION

The ADT in patients with metastatic prostate cancer does not affect patients' cognitive functions and depressive symptoms. However, further prospective randomised studies with higher cohorts and longer follow-up periods are needed.

摘要

研究目的

本研究旨在探讨雄激素剥夺治疗(ADT)对转移性前列腺癌患者睾酮缺乏对认知功能的影响。

方法

在这项多中心前瞻性研究中,评估了 65 例转移性前列腺癌患者。记录人口统计学和临床数据。使用符号数字模态测试、加利福尼亚语言学习测试第二版、简明视觉空间记忆测试修订版和连线测试评估认知功能。使用贝克抑郁量表评估抑郁症状。在 ADT 前和 3 个月和 6 个月随访时记录认知功能和抑郁症状。

结果

在基线认知评估时,平均符号数字模态测试、加利福尼亚语言学习测试第二版、简明视觉空间记忆测试修订版评分分别为 25.84±17.54、32.68±10.60 和 17.63±11.23,连线测试的平均时间为 221.56±92.44 秒,在 3 个月和 6 个月的对照时相似(P>.05)。治疗前、第三个月和第六个月的平均睾酮水平分别为 381.40±157.53ng/dL、21.61±9.09ng/dL 和 12.25±6.45ng/dL(P<.05),总 PSA 水平分别为 46.46±37.83ng/mL、1.41±3.31ng/mL 和 0.08±0.14ng/mL(P<.05)。

结论

ADT 对转移性前列腺癌患者的认知功能和抑郁症状没有影响。然而,需要进一步进行前瞻性随机研究,纳入更大的队列并进行更长时间的随访。

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