Purpose: This umbrella review focused on evaluating the efficacy and adverse events of the metastatic hormone-sensitive prostate cancer patients receiving any treatment regimens, including ADT alone or combination treatments. Methods: This study conducted an umbrella review following the PRISMA 2020 checklist, aiming to summarize the available studies to evaluate the efficacy of medical treatments for metastatic hormone-sensitive prostate cancer. A literature search was performed to identify systematic reviews and meta-analyses (SRMAs) that included only randomized controlled trials (RCTs) up to September 2023. This study summarized their findings, evaluated overlapping data (i.e., the same RCTs were included in >one SRMA), tested for excessive significance (i.e., observed number of statistically significant studies > expected number by chance) and assessed the quality of the studies. Results: A total of 4191 studies were identified, but only 27 were included. Among those 27 studies, 12 were network meta-analyses and 15 were direct meta-analyses. Most studies showed no statistically significant difference in overall mortality among GnRH agonists, antagonists and bilateral orchiectomy. Combination treatment is more beneficial than ADT alone in both OS and PFS outcomes with more adverse events. Nevertheless, there is no OS advantage of any combination regimen over the others. Conclusion: Combination treatments demonstrated clear benefits in OS and PFS over ADT alone with more AEs. Further studies are needed to compare among combination treatments.
目的：本伞状综述旨在评估转移性激素敏感性前列腺癌患者接受任何治疗方案（包括单纯雄激素剥夺疗法或联合治疗）的疗效及不良事件。 方法：本研究遵循PRISMA 2020清单进行伞状综述，旨在总结现有研究以评估转移性激素敏感性前列腺癌药物治疗的疗效。通过文献检索筛选截至2023年9月仅纳入随机对照试验的系统综述和荟萃分析，对其结果进行总结，评估数据重叠性（即同一随机对照试验被纳入多个系统综述/荟萃分析），检验过度显著性（即统计学显著研究的观察数量超过偶然预期值），并评估研究质量。 结果：共检索到4191项研究，最终纳入27项。其中12项为网状荟萃分析，15项为直接荟萃分析。多数研究表明促性腺激素释放激素激动剂、拮抗剂与双侧睾丸切除术在总死亡率方面无统计学显著差异。联合治疗在总生存期和无进展生存期方面均优于单纯雄激素剥夺疗法，但不良事件更多。然而，不同联合治疗方案之间未显示总生存期优势。 结论：联合治疗相比单纯雄激素剥夺疗法在总生存期和无进展生存期方面具有明确获益，但伴随更多不良事件。未来需进一步开展研究比较不同联合治疗方案的差异。
肿瘤(癌症)患者之家