Park Jeongok, Ryu Gi Wook, Lee Hyojin, Choi Young Deuk, Kim Youngkyung
College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea.
Department of Nursing, Hansei University, Gunpo, Korea.
World J Mens Health. 2024 Apr;42(2):347-362. doi: 10.5534/wjmh.220280. Epub 2023 Nov 7.
This study aimed to explore the existing literature on frailty experienced by patients with prostate cancer (PC) receiving androgen deprivation therapy (ADT).
Database and manual searches were conducted to identify relevant studies published in English, with no limitation on the year of publication, according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. Four databases-PubMed, Cochrane Library, EMBASE, and CINAHL-were used for database searches and reference lists, related journals, and Google Scholar were used for manual searches.
A total of 12 studies were analyzed for this scoping review. Of these, only 2 were intervention studies, and 1 was a randomized controlled trial. Among the two intervention studies, the multidisciplinary intervention program, including psychological counseling, nutritional coaching, and supervised group physical exercise did not show significant improvement in frailty. In contrast, high-dose vitamin D supplementation significantly decreased frailty. The conceptual and operational definitions of frailty used in each study varied, and the most used one was mainly focused on physical functions. As a result of analyzing the other health-related variables associated with frailty in patients with PC receiving ADT, age, metastases, comorbidities, and incident falls were related to a high frailty level. As for the physiological index, high levels of C-reactive protein, and interleukin-6, and fibrinogen, low levels of total testosterone, lymphocyte count, and creatinine were associated with a high level of frailty. A few studies explored the relationship between psychological and cognitive variables and frailty.
Further research related to frailty in patients with PC receiving ADT should be conducted, and effective interventions to manage frailty should be developed. Additionally, research that considers not only the physical domain of frailty but also the psychological, cognitive, and social domains needs to be conducted.
本研究旨在探讨接受雄激素剥夺治疗（ADT）的前列腺癌（PC）患者所经历的衰弱相关现有文献。
根据系统评价和Meta分析扩展的范围综述指南，进行数据库检索和手动检索，以识别以英文发表的相关研究，对发表年份无限制。使用四个数据库——PubMed、Cochrane图书馆、EMBASE和CINAHL进行数据库检索，并使用参考文献列表、相关期刊和谷歌学术进行手动检索。
本范围综述共分析了12项研究。其中，只有2项是干预研究，1项是随机对照试验。在这两项干预研究中，包括心理咨询、营养指导和监督下的团体体育锻炼在内的多学科干预方案在衰弱方面未显示出显著改善。相比之下，高剂量补充维生素D显著降低了衰弱程度。每项研究中使用的衰弱概念和操作定义各不相同，最常用的定义主要集中在身体功能上。在分析接受ADT的PC患者中与衰弱相关的其他健康相关变量的结果时，年龄、转移、合并症和跌倒事件与高衰弱水平相关。至于生理指标，高浓度的C反应蛋白、白细胞介素-6和纤维蛋白原，低水平的总睾酮、淋巴细胞计数和肌酐与高衰弱水平相关。少数研究探讨了心理和认知变量与衰弱之间的关系。
应开展与接受ADT的PC患者衰弱相关的进一步研究，并制定有效的衰弱管理干预措施。此外，需要开展不仅考虑衰弱身体领域，还考虑心理、认知和社会领域的研究。
