Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
BJU Int. 2021 Sep;128(3):366-373. doi: 10.1111/bju.15408. Epub 2021 May 7.
To investigate whether bipolar androgen therapy (BAT), involving rapid cyclic administration of high-dose testosterone, as a novel treatment for metastatic castration-resistant prostate cancer (mCRPC) promotes improvements in body composition and associated improvements in lipid profiles and quality of life.
Men from two completed trials with computed tomography imaging at baseline and after three cycles of BAT were included. Cross-sectional areas of psoas muscle, visceral and subcutaneous fat were measured at the L3 vertebral level. Functional Assessment of Chronic Illness Therapy - Fatigue questionnaire and 36-item short-form health survey were used to assess quality of life.
The 60 included patients lost a mean (sd) of 7.8 (8.2)% of subcutaneous fat, 9.8 (18.2)% of visceral fat, and gained 12.2 (6.7)% muscle mass. Changes in subcutaneous and visceral fat were positively correlated with each other (Spearman's correlation coefficient 0.58, 95% confidence interval 0.35-0.71) independent of the effects of age, body mass index, and duration of androgen-deprivation therapy. Energy, physical function, and measures of limitations due to physical health were all significantly improved at 3 months. The improvements in body composition were not correlated with decreases in lipid levels or observed improvements in quality of life.
In the present study, BAT was associated with significant improvements in body composition, lipid parameters, and quality of life. This has promising implications for the long-term health of men with mCRPC.
研究双相雄激素治疗（BAT），即快速循环给予大剂量睾酮，作为转移性去势抵抗性前列腺癌（mCRPC）的一种新治疗方法，是否能改善身体成分，并改善相关的血脂谱和生活质量。
纳入了两项已完成的试验中基线和 BAT 三个周期后进行计算机断层扫描成像的男性患者。在 L3 椎骨水平测量竖脊肌、内脏和皮下脂肪的横截面积。使用慢性病治疗功能评估-疲劳问卷和 36 项简短健康调查问卷评估生活质量。
60 名纳入患者的皮下脂肪平均（标准差）减少了 7.8%（8.2%），内脏脂肪减少了 9.8%（18.2%），肌肉量增加了 12.2%（6.7%）。皮下脂肪和内脏脂肪的变化相互呈正相关（Spearman 相关系数 0.58，95%置信区间 0.35-0.71），与年龄、体重指数和雄激素剥夺治疗的持续时间无关。能量、身体功能以及因身体健康受限的各项指标在 3 个月时均显著改善。身体成分的改善与血脂水平的降低或观察到的生活质量的改善无关。
在本研究中，BAT 与身体成分、血脂参数和生活质量的显著改善相关。这对 mCRPC 男性的长期健康有潜在意义。
