雄激素剥夺疗法（ADT）仍然是晚期前列腺癌患者治疗的基石。 ADT 与多种不良反应相关，包括骨质疏松症、代谢综合征和心血管事件，因此指南建议进行常规检测以监测这些毒性。缺乏评估对这些建议的遵守情况的数据。作者使用 2008 年至 2021 年间加拿大安大略省的行政数据进行了一项回顾性队列研究。他们确定了所有接受 ADT 治疗前列腺癌的老年男性（65 岁及以上），使用综合省级卫生数据库。主要结局是在开始 ADT 前 6 周至后 1 年内检测血脂、血糖异常（葡萄糖）、骨健康血清和骨密度。总共对 29,097 名患者进行了检查，其中 52.8% 接受了处方治疗泌尿科医生开出 ADT，37.9% 由放射肿瘤科医生开出 ADT，2.8% 由肿瘤内科医生开出 ADT，2.4% 由其他医生开出 ADT。对指南的遵守率较低：只有 21.3% 的患者接受了骨密度扫描，41.2% 的患者接受了骨健康相关的血清测试，51.3% 的患者完成了血脂分析，65.9% 的患者在诊断后 1 年内接受了血糖异常测试。总体而言，只有 11.9% 的患者接受了所有建议的检查。随着时间的推移（2008-2021 年）或指南的发布，对测试的遵守似乎并没有得到改善。患者（年龄）和医生（专业）因素与检测的依从性具有重要关联。大多数接受 ADT 治疗前列腺癌的患者没有接受推荐的检测来监测与治疗相关的毒性。需要进一步研究来解决男性 ADT 治疗监测的障碍，并减少与治疗相关的不良事件。© 2024 作者。 《癌症》由 Wiley periodicals LLC 代表美国癌症协会出版。

Androgen-deprivation therapy (ADT) remains a cornerstone in treatment for patients with advanced prostate cancer. ADT is associated with several adverse effects, including osteoporosis, metabolic syndrome, and cardiovascular events, leading to guidelines recommending routine testing to monitor for these toxicities. There is a lack of data assessing adherence to these recommendations.The authors conducted a retrospective cohort study using administrative data from Ontario, Canada between 2008 and 2021. They identified all older men (aged 65 years and older) who received ADT for prostate cancer using comprehensive provincial health databases. The primary outcomes were the use of testing for lipids, dysglycemia (glucose), bone health serum, and bone density between 6 weeks before and 1 year after the initiation of ADT.In total, 29,097 patients were examined, of whom 52.8% were prescribed ADT by urologists, 37.9% were prescribed ADT by radiation oncologists, 2.8% were prescribed ADT by medical oncologists, and 2.4% were prescribed ADT by other physicians. Adherence to guidelines was low: only 21.3% of patients received a bone density scan, 41.2% underwent bone health-related serum tests, 51.3% completed a lipid profile, and 65.9% underwent dysglycemia testing within 1 year of diagnosis. Overall, only 11.9% of patients received all of the recommended investigations. Adherence to testing did not appear to improve over time (2008-2021) or with guideline publication. Patient (age) and physician (specialty) factors had important associations with adherence to testing.Most patients receiving ADT for prostate cancer do not receive recommended testing to monitor for treatment-related toxicity. Further study is required to address barriers to therapeutic monitoring of men on ADT and to reduce treatment-associated adverse events.© 2024 The Author(s). Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.