Prostate cancer （PCa） is the most common malignancy in men. Prostate being an androgen responsive tissue, androgen deprivation therapy （ADT） is used in the management of locally advanced （improves survival） and ...Prostate cancer （PCa） is the most common malignancy in men. Prostate being an androgen responsive tissue, androgen deprivation therapy （ADT） is used in the management of locally advanced （improves survival） and metastatic （improves pain and quality of life） PCa. Over the past two decades, the use of ADT has significantly increased as it is also being used in patients with localized disease and those experiencing biochemical recurrences, though without any evidence of survival advantage. Hypogonadism resulting from ADT is associated with decreased muscle mass and strength, increased fat mass, sexual dysfunction, vasomotor symptoms, decreased quality of life, anemia and bone loss. Insulin resistance, diabetes and cardiovascular disease have recently been added to the list of these complications. As the majority of men with PCa die of conditions other than their primary malignancy, recognition and management of these adverse effects is paramount. Here we review data evaluating metabolic and cardiovascular complications of ADT.展开更多
Studies have investigated the effects of androgen deprivation therapy(ADT)use on the incidence and clinical outcomes of coronavirus disease 2019(COVID-19);however,the results have been inconsistent.We searched the Pub...Studies have investigated the effects of androgen deprivation therapy(ADT)use on the incidence and clinical outcomes of coronavirus disease 2019(COVID-19);however,the results have been inconsistent.We searched the PubMed,Medline,Cochrane,Scopus,and Web of Science databases from inception to March 2022;13 studies covering 84003 prostate cancer(PCa)patients with or without ADT met the eligibility criteria and were included in the meta-analysis.We calculated the pooled risk ratios(RRs)with 95%confidence intervals(CIs)to explore the association between ADT use and the infection risk of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)and severity of COVID-19.After synthesizing the evidence,the pooled RR in the SARS-CoV-2 positive group was equal to 1.17,and the SARS-CoV-2 positive risk in PCa patients using ADT was not significantly different from that in those not using ADT(P=0.544).Moreover,no significant results concerning the beneficial effect of ADT on the rate of intensive care unit admission(RR=1.04,P=0.872)or death risk(RR=1.23,P=0.53)were found.However,PCa patients with a history of ADT use had a markedly higher COVID-19 hospitalization rate(RR=1.31,P=0.015)than those with no history of ADT use.These findings indicate that ADT use by PCa patients is associated with a high risk of hospitalization during infection with SARS-CoV-2.A large number of high quality studies are needed to confirm these results.展开更多
文摘Prostate cancer （PCa） is the most common malignancy in men. Prostate being an androgen responsive tissue, androgen deprivation therapy （ADT） is used in the management of locally advanced （improves survival） and metastatic （improves pain and quality of life） PCa. Over the past two decades, the use of ADT has significantly increased as it is also being used in patients with localized disease and those experiencing biochemical recurrences, though without any evidence of survival advantage. Hypogonadism resulting from ADT is associated with decreased muscle mass and strength, increased fat mass, sexual dysfunction, vasomotor symptoms, decreased quality of life, anemia and bone loss. Insulin resistance, diabetes and cardiovascular disease have recently been added to the list of these complications. As the majority of men with PCa die of conditions other than their primary malignancy, recognition and management of these adverse effects is paramount. Here we review data evaluating metabolic and cardiovascular complications of ADT.
基金This study was supported by the National Natural Science Foundation of China(81972831 and 31800787)the Natural Science Foundation of Liaoning Province(502722)+4 种基金the“Seedling”Project of Young Scientific and Technological Talents of Liaoning Education Department(LR2019008)the United Fund of the Second Hospital of Dalian Medical University and Dalian Institute of Chemical Physics,Chinese Academy of Sciences(UF-QN-202004)the Dalian High-level Talents Innovation Support Program(2019RQ014)the Doctoral Research Startup Foundation of the Second Hospital of Dalian Medical University(DY2Y201704)the Young Reserve Talent Project of the Second Hospital of Dalian Medical University(dy2yhbrc202010).
文摘Studies have investigated the effects of androgen deprivation therapy(ADT)use on the incidence and clinical outcomes of coronavirus disease 2019(COVID-19);however,the results have been inconsistent.We searched the PubMed,Medline,Cochrane,Scopus,and Web of Science databases from inception to March 2022;13 studies covering 84003 prostate cancer(PCa)patients with or without ADT met the eligibility criteria and were included in the meta-analysis.We calculated the pooled risk ratios(RRs)with 95%confidence intervals(CIs)to explore the association between ADT use and the infection risk of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)and severity of COVID-19.After synthesizing the evidence,the pooled RR in the SARS-CoV-2 positive group was equal to 1.17,and the SARS-CoV-2 positive risk in PCa patients using ADT was not significantly different from that in those not using ADT(P=0.544).Moreover,no significant results concerning the beneficial effect of ADT on the rate of intensive care unit admission(RR=1.04,P=0.872)or death risk(RR=1.23,P=0.53)were found.However,PCa patients with a history of ADT use had a markedly higher COVID-19 hospitalization rate(RR=1.31,P=0.015)than those with no history of ADT use.These findings indicate that ADT use by PCa patients is associated with a high risk of hospitalization during infection with SARS-CoV-2.A large number of high quality studies are needed to confirm these results.
