雄激素剥夺疗法与男性患前列腺癌的致命性心脏病发作风险增加相关
这些研究结果发表在9月22日\/ 2015，29个问题的研究信中美国医学会杂志。
"These findings give us reason to rethink how we manage prostate cancer in men with known heart disease," said Anthony D'Amico, MD, lead author of the research paper and chief of genitourinary radiation oncology at Brigham and Women's Hospital。"Specifically, we should be cautious in prescribing ADT in all men who have had a prior heart attack.并；并； Men with significant heart disease that is not amenable to medical or surgical correction may be best served with RT alone."
Researchers compared overall survival and death due to prostate cancer, fatal heart attack and all other causes in a group of 206 men with unfavorable risk prostate cancer who were randomized to receive RT alone or RT and six months of ADT.并； They also categorized the men into subgroups based on extent of prior comorbidity, including prior heart attack.并； After a median follow up exceeding 16 years, researchers found that overall, survival did not differ between the two groups of men。When analyzing the subgroups of men by differing extent of comorbidity, researchers found that among men whose comorbidity included 并；prior heart attack, treatment with RT and ADT shortened survival due to higher rates of fatal heart attacks, while prolonging survival in men with no or minimal comorbidity.
"While there is a growing body of evidence to support active surveillance for men with low risk prostate cancer, men who have unfavorable-risk cancer and significant comorbidity, notably heart disease, may be best served by considering RT alone or possibly active surveillance.并； For these men, the side effects of ADT may be life threatening。并；More research is needed to better understand the newer forms of hormone therapy that do not lower testosterone and how they impact survival," D'Amico said。
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