了解身体功能（PF）和生活质量（QoL）治疗效果对老年癌症患者的治疗决策非常重要。然而，在转移性去势抵抗性前列腺癌（mCRPC）的老年男性中，数据受到限制。我们评估了治疗对mCRPC老年男性的PF和QoL的影响。本研究招募了年龄在65岁及以上的有mCRPC的男性，属于多中心前瞻性观察性研究。 PF测量包括日常生活（IADL），握力，起立椅子和步态速度。 QoL测量包括疲劳，疼痛，情绪和癌症治疗功能评估（FACT）-总体和子量表得分。 结果在基线，三个月和六个月收集。使用线性混合效应回归模型检查不同治疗族群的PF和QoL的时间差异。我们招募了198名接受化疗（n = 71），阿比特龙（n = 37），恩扎鲁胺（n = 67）或镭-223（n = 23）的男性。基线时，开始化疗的男性的PF，QoL，疼痛和情绪测量均比其他组差。随时间推移，所有PF措施保持稳定，疼痛改善，但功能福祉（FWB）和情绪在所有族群中都显著恶化。然而，所有结果随时间变化在不同治疗族群之间并没有明显不同。最坏情况下的敏感性分析确定了我们研究的主要限制（从6个月起范围从22％到42％），特别是对于镭-223族群。FWB和情绪最容易随时间恶化，而疼痛则因治疗而改善。尽管开始化疗的患者具有更差的基线PF和QoL，但化疗与其他常见mCRPC治疗方案相比，在时间上的恶化显著性没有明显不同。这些发现可能有助于与患者进行治疗讨论。但是，考虑到样本量有限，退化和随访时间的限制，这种情况下治疗对PF和QoL结果的影响需要进一步研究，特别是对于镭-223。版权©2022 Elsevier Ltd。保留所有权利。

Understanding physical function (PF) and quality of life (QoL) treatment effects are important in treatment decision-making for older adults with cancer. However, data are limited for older men with metastatic castration-resistant prostate cancer (mCRPC). We evaluated the effects of treatment on PF and QoL in older men with mCRPC.Men aged 65+ with mCRPC were enrolled in this multicenter prospective observational study. PF measures included instrumental activities of daily living, grip strength, chair stands, and gait speed. QoL measures included fatigue, pain, mood, and Functional Assessment of Cancer Therapy (FACT)-General total and sub-scale scores. Outcomes were collected at baseline, three, and six months. Linear mixed effects regression models were used to examine PF and QoL differences over time across various treatment cohorts.We enrolled 198 men starting chemotherapy (n = 71), abiraterone (n = 37), enzalutamide (n = 67), or radium-223 (n = 23). At baseline, men starting chemotherapy had worse measures of PF, QoL, pain, and mood than the other groups. Over time, all PF measures remained stable, pain improved, but functional wellbeing (FWB) and mood worsened significantly for all cohorts. However, change over time in all outcomes was not appreciably different between treatment cohorts. Worst-case sensitivity analyses identified attrition (ranging from 22 to 42% by six months) as a major limitation of our study, particularly for the radium-223 cohort.FWB and mood were most prone to deterioration over time, whereas pain improved with treatment. Although patients initiating chemotherapy had worse baseline PF and QoL, chemotherapy was not associated with significantly greater worsening over time compared to other common therapies for mCRPC. These findings may assist in treatment discussions with patients. However, given the modest sample size, attrition, and timeframe of follow-up, the impact of treatment on PF and QoL outcomes in this setting requires further study, particularly for radium-223.Copyright © 2022 Elsevier Ltd. All rights reserved.