前列腺癌ADT相关骨质疏松症的机制及防治进展

Mechanism of ADT related osteoporosis in prostate cancer and its prospect of prevention and treatment

前列腺癌是男性最常见的癌症及主要死因之一。从20世纪40年代开始人们认识到前列腺癌对雄激素具有高度依赖的特点后,雄激素剥夺治疗(androgen deprivation therapy, ADT)现已成为局限性、复发性和转移性前列腺癌治疗的标准治疗方案。但ADT在治疗前列腺癌的同时却会出现骨质疏松等副作用。就骨质疏松而言,大部分前列腺癌患者在接受ADT前已患有骨质疏松症,接受ADT会使其原有骨质疏松症状加剧,在另一方面又增加了患者骨折的风险。因此探讨ADT相关性骨质疏松发病机制及防治进展已成为前列腺癌内分泌治疗及骨质疏松临床诊疗研究的重点。本文总结了前列腺癌ADT相关骨质疏松近几年来一系列研究成果,就其发病机制及防治进展作以下综述,如ADT相关骨质疏松症中雄激素的作用机制、ADT的药物种类及其作用机制和ADT相关骨质疏松症的研究,为医务工作者们了解前列腺癌ADT相关性骨质疏松发病机制及防治进展提供参考。

Prostate cancer is the most common cancer and one of the main causes of death in men. Since the 1940 s, people have realized that prostate cancer is highly dependent on androgens. Androgen deprivation therapy(ADT) has become the standard treatment for localized, recurrent and metastatic prostate cancer. However, ADT has side effects such as osteoporosis while treating prostate cancer. In terms of osteoporosis, most prostate cancer patients have osteoporosis before receiving ADT. Receiving ADT will aggravate their original osteoporosis symptoms, and on the other hand, increase the risk of fracture. Therefore, to explore the pathogenesis, prevention and treatment of ADT related osteoporosis has become the focus of endocrine therapy of prostate cancer and clinical diagnosis and treatment of osteoporosis. This paper summarizes a series of research result of prostate cancer ADT related osteoporosis in recent years, and summarizes its pathogenesis and prevention and treatment progress as follows, such as the mechanism of action of androgens in ADT related osteoporosis, the types and mechanisms of ADT drugs, and the research on ADT related osteoporosis, so as to provide reference for medical workers to understand the pathogenesis and prevention and treatment progress of prostate cancer ADT related osteoporosis.