Patients and Method
This prospective, multicentric study was carried out in accordance with
the declaration of Helsinki after approval of the Ethics Committee of
Zonguldak Bulent Ecevit University (Date: 18/03/2020; Approval Number:
2020/06). All participants were informed in detail about the design of
the study, and their consent was obtained. For a power analysis, a total
of 48 consecutive men diagnosed with metastatic prostate cancer and
receiving GnRH analogues for ADT were enrolled the study. Cognitive
domains including verbal memory, visual-spatial memory, information
processing speed, and executive functions were evaluated at the third
and sixth month of ADT to discover any change. Patients who had
previously been diagnosed with dementia or psychiatric disease and who
were receiving antidepressant or antipsychotic therapy were excluded.
Patients consuming alcohol or drugs, with a history of systemic
chemotherapy, with central nervous system metastases, with inadequate
vision or hearing impairment that could interfere with neurocognitive
tests and previous brain damage, or who had had brain injury or brain
surgery that could affect cognitive functions were excluded from the
study.
According to the ADT protocol, total prostate-specific antigen (PSA) and
testosterone levels were measured prior to ADT from a fasting morning
venous blood sample using the enzyme-linked immunosorbent assay method.
Patients were given antiandrogen (50 mg bicalutamide per day) for at
least 10 days, then continued with subcutaneous administration of 22.5
mg leuprolide quarterly.