J Urol:雄激素阻断治疗是否会导致痴呆?

2022-01-01 AlexYang MedSci原创

在一个全国性的前列腺癌患者纵向登记处中,评估了累积的ADT暴露与痴呆症发病之间的关系。

雄性激素阻断疗法(ADT)主要用于转移性前列腺癌患者,疾病控制的时间为平均18至24个月。ADT可与局部治疗(如放疗)结合使用,用于高风险局部疾病或根治性前列腺切除术后的辅助治疗,并展示出了其生存益处。到目前为止,ADT的使用几乎增加了10倍,有一半的男性前列腺癌患者在诊断后的某个阶段接受ADT。尽管ADT提供了有效的癌症控制,但ADT对心血管、认知、代谢和肌肉骨骼健康可能产生长期的影响

雄性激素阻断疗法(ADT)与前列腺癌男性痴呆症之间的关系仍然没有定论。近期,来自美国的研究人员在《J Urol》上发表文章,他们在一个全国性的前列腺癌患者纵向登记处中,评估了累积的ADT暴露与痴呆症发病之间的关系

研究包括了登记处中年龄≥50岁的男性。主要结果是治疗后出现的痴呆症情况。接受ADT的概率用倾向性评分来估计。在接受各种治疗的男性中,对倾向评分和临床协变量进行调整后,进行了Cox比例危风险回归,以确定ADT暴露和痴呆症之间的关系。

在13570名男性中,有317人(2.3%)在中位数为7.0年(IQR 3.0-12.0)的随访后诊断出患有痴呆症。累积使用的ADT与痴呆症显著相关(HR 2.02;95% CI 1.40-2.91;P<0.01)。在8506名男性子集中,根据他们是否接受ADT进行倾向性评分匹配发现,ADT的使用与痴呆症之间也有关联(HR 1.59;95% CI 1.03-2.44;p=0.04)。在队列中没有接受ADT的8489名男性中,主要治疗类型与痴呆症的发病则没有关联。

累积的ADT暴露与痴呆发病率的相关性

综上所述,累积的ADT暴露与痴呆症发病率有关。因此,对那些需要接受ADT治疗的患者,应仔细的考虑他们的需求和治疗益处。

原始出处:

Peter E Lonergan , Samuel L Washington 3rd , Janet E Cowan et al. Androgen Deprivation Therapy and the Risk of Dementia after Treatment for Prostate Cancer. J Urol. Dec 2021

 

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    2022-01-01 neuro.Dr

    老年性痴呆,未来还是希望借助神经电生理吧,也许更为有效!

    0

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