前列腺癌 (PCa) 患者的雄激素剥夺疗法 (ADT) 会导致一系列与治疗相关的毒性，从而损害功能和健康相关的生活质量 (HRQoL)。运动已被证明可以对抗许多不利影响，包括 HRQoL 下降；然而，何时开始锻炼尚不清楚。本研究旨在探讨在开始 ADT 时开始锻炼是否比治疗后期开始锻炼更能有效地对抗 HRQoL 的不良影响。开始 ADT 的 PCa 男性（48-84 岁）被随机分配到立即锻炼（IMEX；n = 54）或延迟锻炼 (DEL; n = 48) 12 个月。 IMEX 包括在 ADT 开始时开始的 6 个月监督阻力/有氧/冲击运动以及 6 个月的随访。 DEL 包括 6 个月的常规护理和 6 个月的相同锻炼计划。使用 Short Form-36 在基线、第 6 个月和第 12 个月评估 HRQoL。治疗意向用于分析，包括使用对数转换数据进行组×时​​间重复测量方差分析。身体机能领域（p=0.045）和身体成分总结分数（p=0.045）存在显着的组×时间交互作用0.005），身体疼痛（p < 0.001）和活力领域（p < 0.001）具有显着的时间效应，6 个月时 IMEX 中的 HRQoL 保持不变，DEL 中下降。 DEL 中的锻炼逆转了活力和身体成分总结评分的下降，12 个月时与基线相比没有差异。局限性包括干预期间的治疗改变。PCa 患者同时开始运动和 ADT 可保留 HRQoL，而在既定 ADT 方案期间开始运动可逆转某些 HRQoL 领域的下降。避免初始治疗相关的对健康相关生活质量的不利影响，运动医学应在治疗开始时启动。版权所有 © 2024 作者。由 Elsevier B.V. 出版。保留所有权利。

An array of treatment-related toxicities result from androgen deprivation therapy (ADT) in patients with prostate cancer (PCa), compromising function and health-related quality of life (HRQoL). Exercise has been demonstrated to counter a number of these adverse effects including decreased HRQoL; however, when exercise should be initiated is less clear. This study aims to examine whether commencing exercise when ADT is initiated rather than later during treatment is more effective in countering adverse effects on HRQoL.Men with PCa (48-84 yr) initiating ADT were randomised to immediate exercise (IMEX; n = 54) or delayed exercise (DEL; n = 48) for 12 mo. IMEX consisted of 6 mo of supervised resistance/aerobic/impact exercise commenced at the initiation of ADT with 6 mo of follow-up. DEL consisted of 6 mo of usual care followed by 6 mo of the same exercise programme. HRQoL was assessed using the Short Form-36 at baseline and 6 and 12 mo. Intention to treat was utilised for the analyses that included group × time repeated-measures analysis of variance using log transformed data.There were a significant group × time interaction for the physical functioning domain (p = 0.045) and physical component summary score (p = 0.005), and a significant time effect for bodily pain (p < 0.001) and vitality domains (p < 0.001), with HRQoL maintained in IMEX and declining in DEL at 6 mo. Exercise in DEL reversed declines in vitality and in the physical component summary score, with no differences at 12 mo compared with baseline. Limitations include treatment alterations during the intervention.Concurrently initiating exercise and ADT in patients with PCa preserves HRQoL, whereas exercise initiated while on established ADT regimens reverses declines in some HRQoL domains.To avoid initial treatment-related adverse effects on health-related quality of life, exercise medicine should be initiated at the start of treatment.Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.