Background:Androgen deprivation therapy (ADT) is a primary treatment for prostate cancer (PCa) that effectively reduces androgen levels to suppress tumor progression. However, growing evidence suggests potential cognitive side effects, raising concerns about the long-term neurological consequences of this treatment.Objective:This scoping review aims to synthesize the existing evidence linking ADT to cognitive changes in men with PCa, identifying the key cognitive domains affected and outlining gaps in the existing literature.Methods:A systematic literature search was conducted according to the PRISMA-ScR guidelines in CINAHL, PubMed, Scopus, and Web of Science. Studies investigating cognitive function in ADT-treated PCa patients were included, covering randomized controlled trials (RCTs) and cohort, case–control, and cross-sectional studies. The extracted data included the study design, evaluated cognitive characteristics, measurement tools, and overall findings.Results:A total of 22 studies met the inclusion and exclusion criteria. Cognitive assessments varied across studies. While some studies reported cognitive impairments in ADT-treated patients—particularly in working, verbal, and visual memory and executive function—others found no significant effects. The variability in prostate cancer staging, epidemiological study designs, and treatment regimens; the exclusion of comorbid conditions; and the differences in assessment tools, sample sizes, and study durations hinder definitive conclusions about the cognitive effects of ADT.Conclusions:This scoping review highlights the heterogeneous and often contradictory evidence regarding ADT-associated cognitive dysfunction. While certain cognitive domains may be affected, methodological inconsistencies limit robust conclusions. Standardized cognitive assessments and longer longitudinal studies are required to clarify ADT’s role in cognitive decline. As the PCa survival rate increases with extended ADT use, integrating routine cognitive monitoring into clinical practice should be considered for PCa patients.
背景：雄激素剥夺疗法（ADT）是前列腺癌（PCa）的主要治疗手段，通过有效降低雄激素水平以抑制肿瘤进展。然而，越来越多的证据表明该疗法可能带来认知方面的副作用，引发了对其长期神经学影响的担忧。 目的：本范围综述旨在整合现有关于ADT与前列腺癌患者认知变化关联的证据，识别受影响的关键认知领域，并指出现有文献中的研究空白。 方法：依据PRISMA-ScR指南，在CINAHL、PubMed、Scopus和Web of Science数据库中进行系统性文献检索。纳入的研究包括调查ADT治疗前列腺癌患者认知功能的随机对照试验（RCT）、队列研究、病例对照研究及横断面研究。提取的数据涵盖研究设计、评估的认知特征、测量工具及主要发现。 结果：共22项研究符合纳入与排除标准。各研究的认知评估方法存在差异。部分研究报道ADT治疗患者出现认知功能损害，尤其是在工作记忆、言语记忆、视觉记忆及执行功能方面；而其他研究则未发现显著影响。前列腺癌分期、流行病学研究设计、治疗方案、合并症的排除情况、评估工具、样本量及研究时长的差异，均阻碍了对ADT认知影响的明确结论。 结论：本范围综述揭示了关于ADT相关认知功能障碍的证据存在异质性且常相互矛盾。虽然某些认知领域可能受到影响，但方法学上的不一致限制了得出可靠结论。需要采用标准化的认知评估工具和更长期的纵向研究来明确ADT在认知衰退中的作用。随着ADT长期使用提高前列腺癌生存率，应考虑将常规认知监测纳入前列腺癌患者的临床实践。
肿瘤(癌症)患者之家