文章：

转移性激素敏感性前列腺癌的骨健康现状与改进方向

Bone Health in Metastatic Hormone-Sensitive Prostate Cancer: Where We Stand and Where We Can Improve

原文发布日期：13 December 2025

DOI: 10.3390/cancers17243977

类型: Article

开放获取: 是

英文摘要：

Background: Androgen deprivation therapy (ADT) is a fundamental component of treatment for metastatic hormone-sensitive prostate cancer (mHSPC), but it accelerates bone mineral density loss and increases fracture risk. International guidelines recommend calcium and vitamin D supplementation, baseline dual-energy X-ray absorptiometry (DXA), and antiresorptive therapy in patients with osteoporosis. Methods: We conducted a retrospective review of 156 mHSPC patients treated with ADT at a tertiary hospital between January 2022 and December 2024. We assessed adherence to guideline-recommended bone health measures. Collected variables included age, ADT duration, calcium/vitamin D supplementation, DXA testing, antiresorptive treatment, and fracture events. Exploratory stratified analyses were performed, and proportions were reported with 95% confidence intervals (CIs). Results: Calcium/vitamin D supplementation was prescribed in 50.6% of patients (95% CI: 42.9–58.4), baseline DXA was performed in 12.8% (95% CI: 8.5–18.9), and denosumab was administered in 5.1% of the cohort (95% CI: 2.6–9.8). The median follow-up was 23 months, with a fracture incidence of 0.67 events per 100 person-years. Stratified analyses showed lower adherence in older patients, those with prolonged ADT exposure, and those with high metastatic burden. Conclusions: Adherence to guideline-recommended bone health measures in patients with mHSPC receiving ADT was markedly suboptimal. These findings underscore the need to implement standardized institutional protocols to ensure systematic supplementation, routine DXA monitoring, and appropriate antiresorptive therapy.

摘要翻译： 

背景：雄激素剥夺疗法（ADT）是转移性激素敏感性前列腺癌（mHSPC）治疗的基础组成部分，但会加速骨密度流失并增加骨折风险。国际指南建议对骨质疏松患者补充钙剂和维生素D、进行基线双能X线吸收测定法（DXA）检查并实施抗骨吸收治疗。方法：我们对2022年1月至2024年12月期间在某三级医院接受ADT治疗的156例mHSPC患者进行回顾性分析，评估其对指南推荐骨健康措施的依从性。收集的变量包括年龄、ADT持续时间、钙剂/维生素D补充情况、DXA检测、抗骨吸收治疗及骨折事件。进行了探索性分层分析，比例数据均报告95%置信区间（CI）。结果：50.6%的患者（95% CI：42.9–58.4）接受了钙剂/维生素D补充治疗，12.8%（95% CI：8.5–18.9）完成了基线DXA检查，5.1%的患者（95% CI：2.6–9.8）使用了地舒单抗。中位随访时间为23个月，骨折发生率为每100人年0.67例。分层分析显示老年患者、长期接受ADT治疗者及高转移负荷患者的指南依从性更低。结论：接受ADT治疗的mHSPC患者对指南推荐骨健康措施的依从性显著不足。这些发现强调需要建立标准化的机构诊疗方案，以确保系统性补充治疗、常规DXA监测及规范抗骨吸收治疗的落实。

原文链接：

Bone Health in Metastatic Hormone-Sensitive Prostate Cancer: Where We Stand and Where We Can Improve