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Androgen deprivation therapy for prostate cancer and the risk of hematologic disorders.

前列腺癌的雄激素剥夺治疗与血液系统疾病的风险。

  • 影响因子:3.02
  • DOI:10.1371/journal.pone.0229263
  • 作者列表:"Liu JM","Liu YP","Chuang HC","Wu CT","Su YL","Hsu RJ
  • 发表时间:2020-02-19
Abstract

PURPOSE:This study aimed to investigate the association between androgen deprivation therapy (ADT) and the risk of subsequently developing hematologic disorders in patients with prostate cancer. MATERIALS AND METHODS:This population-based nationwide cohort study utilized data from the Taiwan National Health Insurance Research Database between 1997 and 2013. The patients were divided into three groups-those who received ADT only (ADT-only group), those who had radiotherapy (RT) only (RT-only group), and those treated with radical prostatectomy (RP) only (RP-only group). The study outcome was newly diagnosed hematologic disorder, including anemia and hematologic malignancy. Propensity score-matched, Cox regression, and Kaplan-Meier curve analyses were performed to investigate the risk of subsequently developing hematologic disorders after ADT. RESULTS:Of the 17,168 patients with prostate cancer who were included in the study, 13,318 met the inclusion and exclusion criteria. After propensity score matching, 1,797, 1,797, and 1,797 patients treated with ADT only, RT only, and RP only, respectively, who had a median follow-up period of 4.32 years were included in the study cohort. Compared with the patients treated with RP only, those who received ADT and RT were significantly at increased risk of subsequently developing hematologic disorders (ADT: adjusted hazard ratio [aHR]: 1.60, 95% confidence interval [CI]: 1.29-1.97; RT: aHR, 1.98, 95% CI: 1.62-2.42) according to the Cox regression analysis. Based on the Kaplan-Meier curve analysis, patients with bone metastasis who received ADT only had the lowest cumulative probabilities of not developing hematologic disorders. Moreover, a significantly increased risk of hematologic disorders was observed with the increasing duration of ADT (P for trend < .001). CONCLUSIONS:The use of ADT in patients with prostate cancer may increase the risk of subsequently developing hematologic disorders.

摘要

目的: 本研究旨在探讨雄激素剥夺治疗 (ADT) 与前列腺癌患者随后发生血液病的风险之间的关系。 材料和方法: 这项基于人群的全国性队列研究利用了 1997 年至 2013 年台湾国民健康保险研究数据库的数据。将患者分为三组-仅接受ADT者 (仅ADT组),仅接受放疗 (RT) 者 (仅RT组),和仅接受根治性前列腺切除术 (RP) 的患者 (RP-only组)。研究结果为新诊断的血液系统疾病,包括贫血和血液系统恶性肿瘤。进行倾向评分匹配、Cox回归和Kaplan-Meier曲线分析,以调查ADT后随后发生血液病的风险。 结果: 纳入研究的 17,168 例前列腺癌患者中,13,318 例符合纳入和排除标准。倾向评分匹配后,分别有 1,797 、 1,797 和 1,797 例仅接受ADT、仅接受RT和仅接受RP治疗的患者,中位随访期为 4.32 年的患者被纳入研究队列。与仅接受RP治疗的患者相比,接受ADT和RT的患者随后发生血液病的风险显著增加 (ADT: 校正风险比 [aHR]: 1.60,95% 置信区间 [CI]: 1.29-1.97; RT: aHR,1.98,95% CI: 1.62-2.42)根据Cox回归分析。基于Kaplan-Meier曲线分析,仅接受ADT的骨转移患者未发生血液病的累积概率最低。此外,随着ADT持续时间的增加,血液系统疾病的风险显著增加 (趋势P <.001)。 结论: 在前列腺癌患者中使用ADT可能会增加随后发生血液系统疾病的风险。

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DOI:10.1177/1078155219842277
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骨肿瘤方向

骨肿瘤是发生于骨骼或其附属组织的肿瘤。有良性,恶性之分,良性骨肿瘤易根治,预后良好,恶性骨肿瘤发展迅速,预后不佳,死亡率高。

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