A review of the objective cognitive function measurements in males receiving hormonal therapy for prostate cancer.

IF 2.5 3区 医学 Q2 UROLOGY & NEPHROLOGY Investigative and Clinical Urology Pub Date : 2023-11-01 DOI:10.4111/icu.20230103
Thomas Neerhut, Brian Ng Hung Shin, Handoo Rhee, Eric Chung
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Abstract

Purpose: Prostate cancer (PC) is more common in the older population and the use of hormonal therapy in PC can increase medical frailty and cognitive decline. This narrative review examines the impact of androgen deprivation therapies (ADTs) and next-generational hormonal therapies (NGHT) on cognitive function outcomes amongst patients with hormone-sensitive or castrate-resistant PC.

Materials and methods: Six electronic databases were searched from January 2000 to June 2022 for quantitative studies to evaluate the impacts of hormonal therapies (ADT, combined androgen blockade, and NGHT) on cognitive functions in men with PC.

Results: Of the 36 studies identified, 20 studies reported no effect of hormonal therapies on any cognitive domain while 16 studies found possible declines in at least one domain. The domains assessed were highly variable and objective assessment measurements were not standardized or widely adopted. While the results have been inconsistent, a relationship between declining androgen levels and poorer performances in the visuospatial and visual memory domains has been highlighted. It was not possible to distinguish the degree of cognitive parameter changes between the populations of hormone-sensitive and castrate-resistant PC.

Conclusions: While the exact impact of ADT and NGHT on cognitive function in men with PC remains controversial, appropriate care should be undertaken especially in older and frail individuals, specifically in those with progressive or established visuospatial or visual memory deficits.

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男性接受癌症激素治疗的客观认知功能测量的回顾。
目的:癌症(PC)在老年人群中更常见,在PC中使用激素治疗会增加医疗虚弱和认知能力下降。这篇叙述性综述考察了雄激素剥夺疗法(ADTs)和下一代激素疗法(NGHT)对激素敏感或去势抵抗PC患者认知功能结果的影响。材料和方法:2000年1月至2022年6月,检索了六个电子数据库,以进行定量研究,评估激素疗法的影响(ADT、联合雄激素阻断和NGHT)对PC男性认知功能的影响。结果:在确定的36项研究中,20项研究报告激素治疗对任何认知领域都没有影响,而16项研究发现至少在一个领域可能下降。评估的领域变化很大,客观的评估测量没有标准化或被广泛采用。虽然结果不一致,但雄激素水平下降与视觉空间和视觉记忆领域表现较差之间的关系已得到强调。无法区分激素敏感型和去势抵抗型PC人群的认知参数变化程度。结论:虽然ADT和NGHT对PC男性认知功能的确切影响仍存在争议,但应采取适当的护理措施,尤其是对老年人和体弱者,特别是在那些具有进行性或已建立的视觉空间或视觉记忆缺陷的患者中。
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来源期刊
CiteScore
4.10
自引率
4.30%
发文量
82
审稿时长
4 weeks
期刊介绍: Investigative and Clinical Urology (Investig Clin Urol, ICUrology) is an international, peer-reviewed, platinum open access journal published bimonthly. ICUrology aims to provide outstanding scientific and clinical research articles, that will advance knowledge and understanding of urological diseases and current therapeutic treatments. ICUrology publishes Original Articles, Rapid Communications, Review Articles, Special Articles, Innovations in Urology, Editorials, and Letters to the Editor, with a focus on the following areas of expertise: • Precision Medicine in Urology • Urological Oncology • Robotics/Laparoscopy • Endourology/Urolithiasis • Lower Urinary Tract Dysfunction • Female Urology • Sexual Dysfunction/Infertility • Infection/Inflammation • Reconstruction/Transplantation • Geriatric Urology • Pediatric Urology • Basic/Translational Research One of the notable features of ICUrology is the application of multimedia platforms facilitating easy-to-access online video clips of newly developed surgical techniques from the journal''s website, by a QR (quick response) code located in the article, or via YouTube. ICUrology provides current and highly relevant knowledge to a broad audience at the cutting edge of urological research and clinical practice.
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