摘要
目的探讨多西他赛化疗联合内分泌治疗在转移性激素敏感性前列腺癌患者的疗效和安全性。
方法回顾性分析2015年1月至2016年7月我院192例初治的转移性激素敏感性前列腺癌患者的临床资料。年龄39～93岁，中位年龄71岁。初诊时PSA为4.1～2 556.0 ng/ml，中位值为90.6 ng/ml；180例伴有骨转移，12例伴有远处淋巴结转移。其中61例患者接受多西他赛3周方案化疗联合内分泌治疗（联合化疗组）；131例接受单纯内分泌治疗（单纯内分泌治疗组）。联合化疗组和单纯内分泌治疗组中位年龄分别为67岁（39～80岁）和75岁（50～93岁）（P〈0.001）；两组基线中位PSA水平分别为91.6 ng/ml（35.5～157.5 ng/ml）和89.1 ng/ml（59.6～191.0 ng/ml） （P＝0.324）。病理Gleason评分联合化疗组6分3例（4.9%），7分23例（37.7%），≥8分35例（57.4%）；单纯内分泌治疗组6分17例（13.0%），7分51例（38.9%），≥8分63例（48.1%），两组差异无统计学意义（P＝0.122）。原发灶分期为T3期和T4期患者的比例，联合化疗组分别为50.7%（37/61）和34.4%（21/61），单纯内分泌治疗组分别为60.3%（79/131）和21.4%（28/131），两组差异有统计学意义（P＝0.011）；两组分别有80.3%（49/61）和67.9%（89/131）的患者影像学检查证实有区域淋巴结转移（P＝0.005）。联合化疗组ECOG评分优于单纯内分泌治疗组（平均值：0.15分与0.58分，P〈0.001）。比较两组患者生存情况、PSA缓解率和不良反应发生情况。
结果本组192例均获随访，随访时间14.4～33.4个月，中位时间23.3个月。联合化疗组和单纯内分泌治疗组的中位无进展生存期分别为24.4个月（7.5～31.3个月）与17.5个月（3.0～30.7个月）（P〈0.001），两组分别有1例和16例死于疾病进展。治疗期间联合化疗组和单纯内分泌治疗组PSA降至0.2 ng/ml以下的患者比例分别为29.5%（18/61）和13.7%（18/131）�
ObjectiveTo investigate the efficacy and safety of docetaxel chemotherapy combined with androgen-deprivation therapy （ADT） for patients with metastatic hormone-sensitive prostate cancer.
MethodsOne hundred and ninety-two cases of metastatic hormone-sensitive prostate cancer in Renji Hospital between January 2015 and July 2016 were analyzed retrospectively. Patients′ age was 39 to 90, the median age was 71 years. The median prostate-specific antigen （PSA） at diagnosis was 90.6ng/ml （4.1-2 556.0 ng/ml）. One hundred and eighty were with bone metastasis and 12 were with distant lymphatic metastasis. Sixty-one of them received docetaxel chemotherapy plus ADT for 3 weeks, 131 received hormonal treatment alone. The median age of combination therapy group was 67 years （39-80 years）, that of single treatment group was 75 years （50-93 years） （P〈0.001）. The median PSA baseline of the two groups were 91.6 ng/ml （35.5-157.5ng/ml） and 89.1 ng/ml （59.6-191.0 ng/ml） （P=0.324）. Gleason score of combination therapy group showed that 3 cases （4.9%） was 6, 23 cases （37.7%） 7, 35 cases （57.4%） ≥8. That of single treatment group showed that 17 cases （13.0%） 6, 51 cases （38.9%） 7, 63 cases （48.1%） ≥8. There was no statistic difference between the two groups （P=0.122）. But there was statistic difference in the rate of T3 or T4 clinical stage in primary lesion, that of combination therapy group was 50.7% （37/61） and 34.4% （21/61）, and that of single treatment group was 60.3% （79/131） and 21.4% （28/131） （P=0.011）. Imaging showed local lymph node metastasis in the two groups （80.3% vs. 67.9%, P=0.005）. As to physical condition, the combination therapy group showed a lower ECOG score than the single treatment group （P〈0.001）. All the patients’ survival condition, PSA response rate and adverse events were analyzed.
ResultsOne hundred and ninety-two patients were regularly followed-up. The median follow-up time was 23.3（14.4-33.4）
作者
迟辰斐
樊连城
潘家骅
朱寅杰
沙建军
上官勋
王艳青
董柏君
薛蔚
Chi Chenfei;Fan Liancheng;Pan Jiahua;Zhu Yinjie;Sha Jianjun;Shangguan Xun;Wang Yanqing;Dong Baijun;Xue Wei.(Department of Urology, Renji Hospital, Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai 200127, China)
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2017年第12期927-931,共5页
Chinese Journal of Urology
关键词
前列腺癌
转移性
激素敏感性
多西他赛
内分泌治疗
化疗
无进展生存
Prostatic neoplasms, metastatic, hormone-sensitive
Docetaxel
Androgen deprivation therapy
Chemotherapy
Progression-free survival
