前列腺癌内分泌治疗患者体重管理的最佳证据总结

doi:10.3969/j.issn.1674-8115.2025.02.008

上海交通大学学报（医学版） ›› 2025, Vol. 45 ›› Issue (2): 194-203.doi: 10.3969/j.issn.1674-8115.2025.02.008

• 论著 · 循证医学 • 上一篇

前列腺癌内分泌治疗患者体重管理的最佳证据总结

朱涵菁¹(), 郭艳¹, 殷弘凡², 王贝贝¹, 谢娟¹, 杨艳¹()

^1.上海交通大学医学院附属仁济医院护理部，上海 200127
^2.上海交通大学护理学院，上海 200025

收稿日期:2024-04-12 接受日期:2024-08-19 出版日期:2025-02-28 发布日期:2025-02-28
通讯作者: 杨艳 E-mail:zhu_hanjing@163.com;renji_yy@126.com
作者简介:朱涵菁（1998—），女，硕士，护师；电子信箱：zhu_hanjing@163.com。
基金资助:
国家自然科学基金面上项目(72174120);上海市高水平地方高校创新团队(SHSMU-ZDCX20212800)

Best evidence summary of weight management in patients undergoing endocrine therapy for prostate cancer

ZHU Hanjing¹(), GUO Yan¹, YIN Hongfan², WANG Beibei¹, XIE Juan¹, YANG Yan¹()

^1.Department of Nursing, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
^2.Shanghai Jiao Tong University School of Nursing, Shanghai 200025, China

Received:2024-04-12 Accepted:2024-08-19 Online:2025-02-28 Published:2025-02-28
Contact: YANG Yan E-mail:zhu_hanjing@163.com;renji_yy@126.com
Supported by:
National Natural Science Foundation of China(72174120);Innovation Research Team of High-Level Local Universities in Shanghai(SHSMU-ZDCX20212800)

摘要/Abstract

摘要：

目的·检索并评价前列腺癌患者在内分泌治疗过程中体重管理的相关证据，并总结最佳证据。方法·采用PIPOST模式构建循证问题。按照证据资源“6S”模型，使用计算机自上而下地系统检索国际指南协作网、BMJ最佳临床实践、UpToDate、JBI循证卫生保健中心数据库、美国指南网、医脉通、Cochrane Library、PubMed、CINAHL、Web of Science、Embase、中国知网、中国生物医学文献数据库、万方数据库、维普数据库，以及美国泌尿外科学会、欧洲泌尿外科学会、中华医学会泌尿外科分会网站中关于前列腺癌内分泌治疗过程中体重管理的相关证据，包括指南、临床决策、推荐实践、专家共识、证据总结、系统评价及原始研究。检索时限为建库至2023年12月。由2名研究人员独立对纳入文献进行质量评价。采用逐篇阅读的方式纳入文献，根据主题进行汇总。证据筛选及提取优先选择高等级、高质量、新发表的权威文献。纳入并提取的证据统一采用JBI证据预分级及证据推荐级别系统划分为1~5级，并将证据推荐建议划分为A级强推荐和B级弱推荐。结果·共检索到符合标准的文献12篇，其中指南4篇、专家共识3篇、证据总结2篇、随机对照试验2篇和类实验研究1篇。12篇文献均质量评价较高，全部纳入。最佳证据汇总归纳为体重管理评估及监测、多学科协作、个性化支持、家庭参与策略、营养管理策略、运动管理策略、健康教育和随访管理8个方面。结论·得到前列腺癌内分泌治疗过程中体重管理的最佳证据，归纳为8个方面；临床应用时，还需结合具体临床情况和患者特质，以提高临床干预效果及护理质量。

关键词: 前列腺癌, 内分泌治疗, 体重管理, 循证护理学, 证据总结

Abstract:

Objective ·To retrieve and evaluate evidence related to weight management during endocrine therapy for prostate cancer patients, and summarize the best evidence available. Methods ·The PIPOST model was adopted to construct evidence-based questions. Following the “6S” model of evidence resources, a systematic computer-based search was conducted to retrieve relevant evidence on weight management during prostate cancer endocrine therapy from various databases and websites, including Guidelines International Network, BMJ Best Practice, UpToDate, JBI Evidence-Based Healthcare Center Database, American Guidelines Network, Medlive, Cochrane Library, PubMed, CINAHL, Web of Science, Embase, CNKI, Chinese Biomedical Literature Database, Wanfang Database, and VIP Database, as well as the websites of the American Urological Association, European Urological Association, and Urological Branch of Chinese Medical Association. The evidence retrieved included guidelines, clinical decisions, recommended practices, expert consensuses, evidence summaries, systematic reviews, and original studies. The search period spanned from database establishment to December 2023. Two researchers independently evaluated the quality of the included literature. The included articles were read one by one and summarized according to themes. Priority was given to high-level, high-quality, and newly published authoritative literature during evidence screening and extraction. The included and extracted evidence was uniformly classified into levels 1‒5 according to the JBI evidence pre-classification and evidence recommendation level system, and the evidence recommendations were divided into strongly recommended (Grade A) and weakly recommended (Grade B). Results ·A total of 12 articles were retrieved, consisting of 4 guidelines, 3 expert consensuses, 2 evidence summaries, 2 randomized controlled trials, and 1 quasi-experimental study. All 12 articles were rated as high quality and were included. The best evidence was summarized into 8 aspects: weight management assessment and monitoring, multidisciplinary collaboration, personalized support, family involvement strategies, nutrition management strategies, exercise management strategies, health education, and follow-up management. Conclusion ·The best evidence for weight management during endocrine therapy for prostate cancer is summarized into eight aspects. In clinical application, specific clinical situations and patient characteristics should also be considered to improve the effectiveness of clinical interventions and the quality of care.

Key words: prostate neoplasm, endocrinotherapy, weight management, evidence-based nursing, evidence summary

中图分类号:

R473.73

朱涵菁, 郭艳, 殷弘凡, 王贝贝, 谢娟, 杨艳. 前列腺癌内分泌治疗患者体重管理的最佳证据总结[J]. 上海交通大学学报（医学版）, 2025, 45(2): 194-203.

ZHU Hanjing, GUO Yan, YIN Hongfan, WANG Beibei, XIE Juan, YANG Yan. Best evidence summary of weight management in patients undergoing endocrine therapy for prostate cancer[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2025, 45(2): 194-203.

图/表 6

参考文献 45

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Procedure	Search strategy
#1	prostate neoplasm[MeSH] OR prostate cancer[Title/Abstract] OR PCa[Title/Abstract] OR prostate tumor[Title/Abstract] OR prostate neoplasms[Title/Abstract]
#2	endocrinotherapy[Title/Abstract] OR androgen deprivation therapy[Title/Abstract] OR anti androgen[Title/Abstract] OR ADT[Title/Abstract] OR anti androgenic therapy[Title/Abstract]
#3	nutrition[Title/Abstract] OR dietary[Title/Abstract] OR diet[MeSH] OR weight[Title/Abstract] OR nutritional[Title/Abstract] OR food[MeSH]
#4	#1 AND #2 AND #3

Procedure	Search strategy
#1	prostate neoplasm[MeSH] OR prostate cancer[Title/Abstract] OR PCa[Title/Abstract] OR prostate tumor[Title/Abstract] OR prostate neoplasms[Title/Abstract]
#2	endocrinotherapy[Title/Abstract] OR androgen deprivation therapy[Title/Abstract] OR anti androgen[Title/Abstract] OR ADT[Title/Abstract] OR anti androgenic therapy[Title/Abstract]
#3	nutrition[Title/Abstract] OR dietary[Title/Abstract] OR diet[MeSH] OR weight[Title/Abstract] OR nutritional[Title/Abstract] OR food[MeSH]
#4	#1 AND #2 AND #3

Included literature	Literature type	Language	Research theme	Publication year
GONG, et al^[16]	Evidence summary	Chinese	Non-pharmacological management of osteoporosis in androgen-deprived patients with prostate cancer	2022
FANKHAUSER, et al^[17]	Evidence summary	English	Indications and complications of androgen deprivation therapy	2020
BARNES, et al^[18]	Guideline	English	Weight management in prostate cancer patients undergoing androgen deprivation therapy	2019
OWEN, et al^[19]	Guideline	English	Lifestyle management in patients undergoing androgen deprivation therapy for prostate cancer	2017
NOONAN, et al^[20]	Guideline	English	Care for prostate cancer survivors	2016
RESNICK, et al^[21]	Guideline	English	Prostate cancer survival care guidelines	2015
Chinese Society of Nutritional Oncology, et al^[22]	Expert consensus	Chinese	Nutritional therapy for prostate cancer patients	2021
Urological Health Promotion Branch of China International Exchange and Promotion Association for Medical and Health Care, et al^[23]	Expert consensus	Chinese	Consensus on the safety of classical endocrine therapy for prostate cancer	2018
GROSSMANN, et al^[24]	Expert consensus	English	Skeletal and metabolic management in prostate cancer patients treated with androgen deprivation	2011
FAN, et al^[25]	RCT	Chinese	Effects of multi-dimensional family survival programs on health-related quality of life in patients undergoing endocrine therapy	2021
GREASLEY^[26]	RCT	English	Lifestyle intervention in castrated prostate cancer patients	2018
BULTIJNCK, et al^[27]	quasi-RCT	English	Evidence-based strategies to improve side effects of androgen deprivation therapy in prostate cancer patients	2018

Included literature	Literature type	Language	Research theme	Publication year
GONG, et al^[16]	Evidence summary	Chinese	Non-pharmacological management of osteoporosis in androgen-deprived patients with prostate cancer	2022
FANKHAUSER, et al^[17]	Evidence summary	English	Indications and complications of androgen deprivation therapy	2020
BARNES, et al^[18]	Guideline	English	Weight management in prostate cancer patients undergoing androgen deprivation therapy	2019
OWEN, et al^[19]	Guideline	English	Lifestyle management in patients undergoing androgen deprivation therapy for prostate cancer	2017
NOONAN, et al^[20]	Guideline	English	Care for prostate cancer survivors	2016
RESNICK, et al^[21]	Guideline	English	Prostate cancer survival care guidelines	2015
Chinese Society of Nutritional Oncology, et al^[22]	Expert consensus	Chinese	Nutritional therapy for prostate cancer patients	2021
Urological Health Promotion Branch of China International Exchange and Promotion Association for Medical and Health Care, et al^[23]	Expert consensus	Chinese	Consensus on the safety of classical endocrine therapy for prostate cancer	2018
GROSSMANN, et al^[24]	Expert consensus	English	Skeletal and metabolic management in prostate cancer patients treated with androgen deprivation	2011
FAN, et al^[25]	RCT	Chinese	Effects of multi-dimensional family survival programs on health-related quality of life in patients undergoing endocrine therapy	2021
GREASLEY^[26]	RCT	English	Lifestyle intervention in castrated prostate cancer patients	2018
BULTIJNCK, et al^[27]	quasi-RCT	English	Evidence-based strategies to improve side effects of androgen deprivation therapy in prostate cancer patients	2018

Included literature	Item 1	Item 2	Item 3	Item 4	Item 5	Item 6	Item 7	Item 8	Item 9	Item 10
GONG, et al^[16]	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
FANKHAUSER, et al^[17]	Yes	Yes	No	Partly yes	No	Yes	Yes	Yes	Yes	Yes

前列腺癌内分泌治疗患者体重管理的最佳证据总结

Best evidence summary of weight management in patients undergoing endocrine therapy for prostate cancer

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参考文献 45

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Metrics

Included literature	Standardization percentage by field/%						Number of fields with a standardization percentage ≥60%/n	Number of fields with a standardization percentage ≥30%/n	Recommendation level
Included literature	Scope and purpose	Stakeholder involvement	Rigor of development	Clarity of presentation	Applicability	Editorial independence	Number of fields with a standardization percentage ≥60%/n	Number of fields with a standardization percentage ≥30%/n	Recommendation level
NOONAN, et al^[20]	94.44	83.33	58.33	83.33	62.50	75.00	5	6	B
RESNICK, et al^[21]	100.00	88.89	85.41	88.89	70.83	66.67	6	6	A
BARNES, et al^[18]	100.00	94.44	91.67	94.44	87.50	91.67	6	6	A
OWEN, et al^[19]	100.00	94.44	93.75	83.33	79.17	75.00	6	6	A

Included literature	Item 1	Item 2	Item 3	Item 4	Item 5	Item 6	Recommendation level
Chinese Society of Nutritional Oncology, et al^[22]	Yes	Yes	Yes	Yes	Yes	Unclear	A
Urological Health Promotion Branch of China International Exchange and Promotion Association for Medical and Health Care, et al^[23]	No	Yes	Yes	Yes	Yes	Unclear	B
GROSSMANN, et al^[24]	Yes	Yes	Yes	Yes	Yes	No	A

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