去势治疗会增加患致命心脏病的风险

去势治疗会增加患致命心脏病的风险

Long term follow up indicates that men with comorbidity, predominately a prior heart attack, who received androgen deprivation1 therapy(ADT) died earlier, due to a fatal heart attack. Androgen deprivation therapy (ADT) and radiation therapy (RT) is known to prolong survival in men with unfavorable-risk prostate cancer and is considered a standard of care. However, in 2008, the FDA implemented2 a black box warning about ADT use for prostate cancer due to evidence that suggested an increased risk in non-fatal cardiovascular events. The association of ADT use and fatal heart attacks has remained uncertain until now. Specifically, long term follow up of a randomized clinical trial that compared ADT and radiation therapy (RT) to RT alone finds that men with significant comorbidity; most commonly prior heart attack, who received ADT died earlier, due to a fatal heart attack, compared to men who did not receive ADT.

These findings are published in a research letter in the September 22/29, 2015 issue of the Journal of the American Medical Association.

"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. Men with significant heart disease that is not amenable3 to medical or surgical4 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. They also categorized the men into subgroups based on extent of prior comorbidity, including prior heart attack. After a median follow up exceeding 16 years, researchers found that overall, survival did not differ between the two groups of men. When analyzing5 the subgroups of men by differing extent of comorbidity, researchers found that among men whose comorbidity included 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 minimal6 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, notably7 heart disease, may be best served by considering RT alone or possibly active surveillance. For these men, the side effects of ADT may be life threatening. More research is needed to better understand the newer forms of hormone8 therapy that do not lower testosterone and how they impact survival," D'Amico said.

1 deprivation

n.匮乏；丧失；夺去，贫困

参考例句：

Many studies make it clear that sleep deprivation is dangerous.多实验都证实了睡眠被剥夺是危险的。

Missing the holiday was a great deprivation.错过假日是极大的损失。

2 implemented

v.实现( implement的过去式和过去分词 )；执行；贯彻；使生效

参考例句：

This agreement, if not implemented, is a mere scrap of paper. 这个协定如不执行只不过是一纸空文。 来自《现代汉英综合大词典》

The economy is in danger of collapse unless far-reaching reforms are implemented. 如果不实施影响深远的改革，经济就面临崩溃的危险。 来自辞典例句

3 amenable

adj.经得起检验的；顺从的；对负有义务的

参考例句：

His scientific discoveries are amenable to the laws of physics.他在科学上的发现经得起物理定律的检验。

He is amenable to counsel.他这人听劝。

4 surgical

adj.外科的，外科医生的，手术上的

参考例句：

He performs the surgical operations at the Red Cross Hospital.他在红十字会医院做外科手术。

All surgical instruments must be sterilised before use.所有的外科手术器械在使用之前，必须消毒。

5 analyzing

v.分析；分析( analyze的现在分词 )；分解；解释；对…进行心理分析n.分析

参考例句：

Analyzing the date of some socialist countries presents even greater problem s. 分析某些社会主义国家的统计数据，暴露出的问题甚至更大。 来自辞典例句

He undoubtedly was not far off the mark in analyzing its predictions. 当然，他对其预测所作的分析倒也八九不离十。 来自辞典例句

6 minimal

adj.尽可能少的，最小的

参考例句：

They referred to this kind of art as minimal art.他们把这种艺术叫微型艺术。

I stayed with friends, so my expenses were minimal.我住在朋友家，所以我的花费很小。

7 notably

adv.值得注意地，显著地，尤其地，特别地

参考例句：

Many students were absent,notably the monitor.许多学生缺席，特别是连班长也没来。

A notably short,silver-haired man,he plays basketball with his staff several times a week.他个子明显较为矮小，一头银发，每周都会和他的员工一起打几次篮球。

8 hormone

n.荷尔蒙，激素，内分泌

参考例句：

Hormone implants are used as growth boosters.激素植入物被用作生长辅助剂。

This hormone interacts closely with other hormones in the body.这种荷尔蒙与体內其他荷尔蒙紧密地相互作用。