在转移性激素敏感型前列腺癌(mHSPC)患者中，雄激素受体信号抑制剂（ARSIs）在雄激素剥夺治疗（ADT）中的应用可提高总生存率，但相关健康相关生命质量（HR-QoL）信息较少。本文旨在汇总目前关于ARSIs对HR-QoL影响的证据。我们通过对2022年1月至4月的PubMed/EMBASE、Web of Science、SCOPUS和Cochrane图书馆出版物进行系统回顾，且 根据PRISMA指南选择只包括III期随机对照试验（RCT）。我们旨在通过经过验证的患者报告的结果评估HR-QoL的差异。我们分析了全球得分和亚组领域，例如性功能、尿路症状、肠道症状、疼痛/疲劳、情感和社会/家庭幸福感。我们通过描述数据来报告结果。共纳入6项RCT：其中两项使用恩扎鲁胺与ADT作为干预措施(ARCHES、ENZAMET)；一项使用阿帕鲁胺与ADT(TITAN)；两项使用乙酰酪酸阿比特龙和强的松龙与ADT（STAMPEDE、LATITUDE），以及一项使用多沙普胺与ADT（ARASENS）。与单独ADT、ADT与第一代非甾体性抗雄激素或ADT与多西他赛相比，恩扎鲁胺或乙酰酪酸阿比特龙与ADT联合使用可提高总体HR-QoL，而阿帕鲁胺和多沙普胺与ADT联合使用可以维持HR-QoL类似于单独ADT或ADT与多西他赛。联合治疗恩扎鲁胺、乙酰酪酸阿比特龙或多沙普胺可延长疼痛初次恶化的时间，但阿帕鲁胺则不然。与单独ADT相比，ARSIs的加入对情感幸福感的恶化报告较少。在mHSPC中，将ARSIs添加到ADT中倾向于提高总体HR-QoL，延长疼痛/疲劳首次恶化的时间，但与ADT单独、ADT与第一代非甾体性抗雄激素或ADT与多西他赛相比。ARSIs对其余HR-QoL领域表现出复杂的相互作用。我们主张标准化HR-QoL测量和报告，以便进一步进行比较。 ©2023.作者，独家授权Springer Nature Limited发表。

While the addition of androgen receptor signaling inhibitors (ARSIs) to androgen deprivation therapy (ADT) results in better of overall survival in patients with metastatic hormone-sensitive prostate cancer (mHSPC), information regarding health related quality of life (HR-QoL) is sparse. We aimed at summarizing current evidence on the impact of ARSIs on HR-QoL.We performed a systematic review of the published literature on PubMed/EMBASE, Web of Science, SCOPUS, and the Cochrane libraries between January 2011 and April 2022. We included only phase III randomized controlled trials (RCT), which were selected according to the PRISMA guidelines. We aimed at evaluating differences in HR-QoL, assessed by validated patient reported outcomes instruments. We analyzed global scores and sub-domains such as sexual functioning, urinary symptoms, bowel symptoms, pain/fatigue, emotional and social/family wellbeing. We reported data descriptively.Six RCTs were included: two used enzalutamide with ADT as intervention arms (ARCHES, ENZAMET); one used apalutamide with ADT (TITAN); two abiraterone acetate and prednisone (AAP) with ADT (STAMPEDE, LATITUDE); and one darolutamide with ADT (ARASENS). Enzalutamide or AAP with ADT increase overall HR-QoL in comparison with ADT alone, ADT with first generation nonsteroideal anti-androgens or ADT with docetaxel, whereas apalutamide and darolutamide with ADT maintain HR-QoL similarly to ADT alone or ADT with docetaxel, respectively. Time to first deterioration of pain was longer with combination therapy with enzalutamide, AAP or darolutamide, but not with apalutamide. No worsening of emotional wellbeing was reported from the addition of ARSIs to ADT than ADT alone.The addition of ARSIs to ADT in mHSPC tends to increase overall HR-QoL and prolong time to first deterioration of pain/fatigue compared with ADT alone, ADT with first generation nonsteroideal anti-androgens, and ADT with docetaxel. ARSIs show a complex interaction with remaining HR-QoL domains. We advocate a standardization of HR-QoL measurement and reporting to allow further comparisons.© 2023. The Author(s), under exclusive licence to Springer Nature Limited.