Burden of Treatment-Induced Vasomotor Symptoms in Men With Prostate Cancer on Androgen-Deprivation Therapy: A Systematic Literature Review.

چکیده اصلی

BACKGROUND: Androgen-deprivation therapy (ADT) for prostate cancer (PCa) is associated with vasomotor symptoms (VMS; hot flashes and night sweats). However, the impact of VMS has not been well characterized. This systematic literature review analyzed patient-reported outcome (PRO) instruments used to assess the quality of life (QoL) impact of ADT-induced VMS as well as the associated humanistic burden and epidemiology. METHODS: MEDLINE In-Progress, Embase, Cochrane Database of Systematic Reviews (2011-2024), and major oncology and health economics and outcomes research conferences (2023-2024) were searched. RESULTS: In total, 52 studies were included. Of 15 PRO instruments identified, the most common were the Hot Flash-Related Daily Interference Scale, the Expanded Prostate Index Composite-26, and hot flash daily diaries. No PRO instrument was specifically validated to assess the effect of ADT-induced VMS on QoL in PCa. VMS severity (including subjective burden) was significantly associated with QoL, whereas VMS frequency was not. However, no consensus exists on VMS severity definitions. VMS negatively affected sexual functioning, interpersonal relationships, and/or work productivity, and the associated anxiety, fatigue, insomnia, and poor sleep quality were found to impair QoL. VMS additionally appeared to mediate ADT's impact on sleep disturbance. ADT-induced VMS rates ranged from 1.4% to 68.9%, with higher frequencies reported within 3-6 months of ADT initiation and when adverse events were actively monitored or participants asked to report/record VMS events (30.7%-68.9%). Lower frequencies were seen when VMS were spontaneously captured or in retrospective analyses without active VMS monitoring/reporting (1.4%-15.8%) and with enzalutamide, apalutamide, and abiraterone as add-on therapy to ADT (13.9%-15.8%). CONCLUSIONS: VMS severity in men with PCa is more consistently associated with QoL impact versus VMS frequency. A need for PRO instruments specific to treatment-related VMS in PCa and a lack of consensus on definitions of severity for ADT-induced VMS in PCa were identified.

ترجمه فارسی چکیده

درمان حذف آندروژن (ADT) برای سرطان پروستات با علائم عروقی (VMS؛ لرز و عرق شبانه) همراه است. این مرور نظام‌مند ادبیات، ابزارهای گزارش‌دهی نتایج توسط بیمار (PRO) را برای ارزیابی تأثیر کیفیت زندگی (QoL) ناشی از VMS و بار انسانی و اپیدمیولوژی آن‌ها تحلیل کرد. ۵۲ مطالعه شامل شد. از ۱۵ ابزار PRO شناسایی شده، رایج‌ترین‌ها مقیاس تداخل روزانه مرتبط با لرز، ترکیب شاخص پروستات گسترده-۲۶ و دفترچه روزانه لرز بودند. هیچ ابزار PRO به طور خاص برای ارزیابی تأثیر VMS ناشی از ADT بر QoL در سرطان پروستات تایید نشده است. شدت VMS (شامل بار ذهنی) با QoL مرتبط بود، اما فرکانس آن نه. VMS بر عملکرد جنسی، روابط بین‌فردی و/یا بهره‌وری کاری تأثیر منفی داشت و اضطراب، خستگی، بی‌خوابی و کیفیت ضعیف خواب مرتبط با آن، QoL را مختل کردند. VMS به نظر می‌رسد در تأثیر ADT بر اختلال خواب مداخله کند. نرخ‌های VMS ناشی از ADT بین ۱.۴٪ تا ۶۸.۹٪ ranged. شدت VMS در مردان مبتلا به سرطان پروستات به طور منسجم‌تر با تأثیر QoL نسبت به فرکانس VMS مرتبط است.

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