JAMA Oncol:去势治疗会增加前列腺癌患者的痴呆症风险

2016-10-19 MedSci MedSci原创

越来越多的证据表明,雄激素阻断疗法(去势治疗,ADT)与包括阿尔茨海默病在内的认知功能障碍有关。 但是关于ADT和痴呆症(老年性痴呆、血管性痴呆、额颞叶痴呆、阿尔茨海默病性痴呆)风险之间的联系还不太清楚。 研究纳入了9455例≥18岁的前列腺癌患者,中位数随访3.4年。排除183例既往诊断为痴呆症的患者。最终的队列包括9272例前列腺啊患者,其中1826(19.7%)例接受ADT治疗。

越来越多的证据表明,雄激素阻断疗法(去势治疗,ADT)与包括阿尔茨海默病在内的认知功能障碍有关。

但是关于ADT和痴呆症(老年性痴呆、血管性痴呆、额颞叶痴呆、阿尔茨海默症痴呆)风险之间的联系还不太清楚。

研究纳入了9455例≥18岁的前列腺癌患者,中位数随访3.4年。排除183例既往诊断为痴呆症的患者。最终的队列包括9272例前列腺癌患者,其中1826(19.7%)例接受ADT治疗。

9272例前列腺癌患者(平均[SD]年龄,66.9 [ 10.9 ]岁;5450 [ 58.8% ]例为白人)中,ADT和痴呆症风险之间存在显著联系(HR 2.17; 95% CI, 1.58-2.99; P <0 .001)。

排除阿尔茨海默病患者后进行的敏感性分析,得出相似的结论(HR 2.32; 95% CI, 1.73-3.12; P <0 .001)。

接受ADT治疗的患者中,第5年增加的痴呆症绝对风险为4.4%(接受ADT治疗 vs 不接受ADT治疗,7.9% vs 3.5%)。

根据ADT治疗时间进行分层分析,使用ADT治疗至少12个月的患者,其增加的痴呆症绝对风险最大(HR 2.36; 95% CI, 1.64-3.38; P <0 .001)。

Kaplan-Meier分析表明,≥70岁患者使用ADT,有最低的剩余无痴呆症累积概率(log-rank P <0 .001)。

结果表明,前列腺癌治疗过程中,去势治疗会增加患者的痴呆症风险。

原始出处:

Kevin T. Nead,et al.Association Between Androgen Deprivation Therapy and Risk of Dementia.JAMA Oncol. Published online October 13, 2016

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    2017-02-07 Boyinsh
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  4. [GetPortalCommentsPageByObjectIdResponse(id=1632059, encodeId=a34e1632059db, content=<a href='/topic/show?id=003b3e23745' target=_blank style='color:#2F92EE;'>#去势治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37237, encryptionId=003b3e23745, topicName=去势治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=02f721846554, createdName=zhaozuguo, createdTime=Thu May 04 12:57:00 CST 2017, time=2017-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1836128, encodeId=51ec1836128ba, content=<a href='/topic/show?id=4613e1212fc' target=_blank style='color:#2F92EE;'>#痴呆症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71212, encryptionId=4613e1212fc, topicName=痴呆症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=726030, createdName=Boyinsh, createdTime=Tue Feb 07 03:57:00 CST 2017, time=2017-02-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1864826, encodeId=ef8a1864826b6, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Thu Feb 16 14:57:00 CST 2017, time=2017-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=150451, encodeId=76c01504510f, content=这个有意思了,前列腺癌在国内主要还是老年群体,痴呆也是老年高发,而前列腺癌一般不是直接死因,因此如何权衡利弊很重要。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7f951969894, createdName=1e15ab23m02(暂无匿称), createdTime=Sat Oct 22 22:41:31 CST 2016, time=2016-10-22, status=1, ipAttribution=)]
    2016-10-22 1e15ab23m02(暂无匿称)

    这个有意思了,前列腺癌在国内主要还是老年群体,痴呆也是老年高发,而前列腺癌一般不是直接死因,因此如何权衡利弊很重要。

    0

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