Maxine Sun1, Alexander P Cole2, Nawar Hanna2, Lorelei A Mucci3, Donna L Berry4, Shehzad Basaria5, David K Ahern6, Adam S Kibel2, Toni K Choueiri7, Quoc-Dien Trinh8. 1. Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Division of Urological Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: maxine_sun@dfci.harvard.edu. 2. Division of Urological Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. 3. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. 4. Phyllis F. Cantor Center, Dana-Farber Cancer Institute, Boston, Massachusetts. 5. Research Program in Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts. 6. Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. 7. Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts. 8. Division of Urological Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: qtrinh@bwh.harvard.edu.
Abstract
PURPOSE: Use of androgen deprivation therapy may increase the risk of cognitive impairment in men with prostate cancer. We performed a systematic review of the risk of overall cognitive impairment as an outcome in men receiving androgen deprivation therapy for prostate cancer. MATERIALS AND METHODS: Studies were identified through PubMed®, MEDLINE®, PsycINFO®, Cochrane Library and Web of Knowledge/Science™. Articles were included if they 1) were published in English, 2) had subjects treated for prostate cancer with androgen deprivation therapy, 3) incorporated longitudinal comparisons and 4) used control groups. In addition, prospective studies were required to assess an established cognitive related end point using International Cognition and Cancer Task Force criteria defining impaired cognitive performance as scoring 1.5 or more standard deviations below published norms on 2 or more tests, or scoring 2.0 or more standard deviations below published norms on at least 1 test. The effect of androgen deprivation therapy on cognitive impairment was pooled using a random effects model. RESULTS: Of 221 abstracts 26 were selected for full text review, and 2 prospective and 4 retrospective studies were analyzed. Androgen deprivation therapy was not associated with overall cognitive impairment when the prospective cohort studies were pooled (OR 1.57, 95% CI 0.50 to 4.92, p = 0.44) with significant heterogeneity between estimates (I2 = 83%). In retrospective data the relative risk of any cognitive impairment, including senile dementia and Alzheimer disease, was increased in men receiving androgen deprivation therapy, although the difference was not statistically significant (HR 1.28, 95% CI 0.93 to 1.76, p = 0.13) with moderate heterogeneity between estimates (I2 = 67%). CONCLUSIONS: Analyses between overall cognitive impairment and use of androgen deprivation therapy defined according to International Cognition and Cancer Task Force criteria in a pooled analysis were inconclusive. In retrospective cohort studies the risk of overall cognitive impairment after androgen deprivation therapy was not significant. Better prospective studies need to be designed for the assessment of this end point.
PURPOSE: Use of androgen deprivation therapy may increase the risk of cognitive impairment in men with prostate cancer. We performed a systematic review of the risk of overall cognitive impairment as an outcome in men receiving androgen deprivation therapy for prostate cancer. MATERIALS AND METHODS: Studies were identified through PubMed®, MEDLINE®, PsycINFO®, Cochrane Library and Web of Knowledge/Science™. Articles were included if they 1) were published in English, 2) had subjects treated for prostate cancer with androgen deprivation therapy, 3) incorporated longitudinal comparisons and 4) used control groups. In addition, prospective studies were required to assess an established cognitive related end point using International Cognition and Cancer Task Force criteria defining impaired cognitive performance as scoring 1.5 or more standard deviations below published norms on 2 or more tests, or scoring 2.0 or more standard deviations below published norms on at least 1 test. The effect of androgen deprivation therapy on cognitive impairment was pooled using a random effects model. RESULTS: Of 221 abstracts 26 were selected for full text review, and 2 prospective and 4 retrospective studies were analyzed. Androgen deprivation therapy was not associated with overall cognitive impairment when the prospective cohort studies were pooled (OR 1.57, 95% CI 0.50 to 4.92, p = 0.44) with significant heterogeneity between estimates (I2 = 83%). In retrospective data the relative risk of any cognitive impairment, including senile dementia and Alzheimer disease, was increased in men receiving androgen deprivation therapy, although the difference was not statistically significant (HR 1.28, 95% CI 0.93 to 1.76, p = 0.13) with moderate heterogeneity between estimates (I2 = 67%). CONCLUSIONS: Analyses between overall cognitive impairment and use of androgen deprivation therapy defined according to International Cognition and Cancer Task Force criteria in a pooled analysis were inconclusive. In retrospective cohort studies the risk of overall cognitive impairment after androgen deprivation therapy was not significant. Better prospective studies need to be designed for the assessment of this end point.
Authors: Mackenzi Pergolotti; Nicolò Matteo Luca Battisti; Lynne Padgett; Alix G Sleight; Maya Abdallah; Robin Newman; Kathleen Van Dyk; Kelley R Covington; Grant R Williams; Frederiek van den Bos; YaoYao Pollock; Elizabeth A Salerno; Allison Magnuson; Isabella F Gattás-Vernaglia; Tim A Ahles Journal: J Geriatr Oncol Date: 2019-10-14 Impact factor: 3.599
Authors: Omar Saeed; Lori J Bernstein; Rouhi Fazelzad; Mary Samuels; Lynn A Burmeister; Lehana Thabane; Shereen Ezzat; David P Goldstein; Jennifer Jones; Anna M Sawka Journal: J Cancer Surviv Date: 2019-04-04 Impact factor: 4.442
Authors: Kim Edmunds; Haitham Tuffaha; Daniel A Galvão; Paul Scuffham; Robert U Newton Journal: Support Care Cancer Date: 2020-01-07 Impact factor: 3.603
Authors: Cecilie R Buskbjerg; Ali Amidi; Simon Buus; Claus H Gravholt; S M Hadi Hosseini; Robert Zachariae Journal: Prostate Cancer Prostatic Dis Date: 2021-06-04 Impact factor: 5.554
Authors: Konstantina G Yiannopoulou; Aikaterini I Anastasiou; Konstantinos Kontoangelos; Charalambos Papageorgiou; Ioannis P Anastasiou Journal: Curr Urol Date: 2020-12-18