目的调查转移性去势抵抗性前列腺癌(metastatic castration resistant prostate cancer,mCRPC)化疗患者疾病应对方式特点和生存质量现状,探讨二者关系,为临床实践中改善mCRPC化疗患者疾病应对方式和生存质量提供依据。方法2019-01/2020...目的调查转移性去势抵抗性前列腺癌(metastatic castration resistant prostate cancer,mCRPC)化疗患者疾病应对方式特点和生存质量现状,探讨二者关系,为临床实践中改善mCRPC化疗患者疾病应对方式和生存质量提供依据。方法2019-01/2020-06月,采用便利抽样法选取兰州市3家三级甲等医院泌尿外科或肿瘤科接受化疗的391例mCRPC患者作为研究对象。利用患者一般人口学及疾病相关信息问卷、晚期患者生存质量量表(quality of life concerns in the end of life questionnaire,QOLC-E)及医学应对方式问卷进行调查。分析患者疾病应对方式、生存质量现状,同时分析应对方式与生存质量间的关系。结果mCRPC化疗患者生存质量总分为(2.92±0.38)分,mCRPC化疗患者生存质量与屈服、回避策略呈负相关(P<0.05),与面对应对策略呈正相关(P<0.01)。结论医护人员应指导患者建立积极的疾病应对态度,重视疾病应对方式对患者生存质量的影响,通过引导患者重塑积极的疾病应对方式来改善其生存质量。展开更多
Several recent studies in mCRPC have identified the mechanisms of tumoral growth after the disease becomes unresponsive to standard hormonal therapy. These studies have highlighted the importance of residual intratumo...Several recent studies in mCRPC have identified the mechanisms of tumoral growth after the disease becomes unresponsive to standard hormonal therapy. These studies have highlighted the importance of residual intratumoral androgens in maintaining androgen receptor (AR) transcriptional activity in mCRPC [1]. Based on this findings, it has been possible to develop drugs, blocking the key enzyme in the biosynthesis of androgens through the inhibition of cytochrome p450 17 (CYP17) such as Abiraterone Acetate (AA) and drugs which directly target the AR including Enzalutamide (E) and Orteronel. Before this new knowledge, mCRPC treatment benefited from chemotherapy with taxanes. Recently a new taxane, Cabazitaxel (C), was approved in second line setting in association with prednisone. Retrospective analyses have tried to clarify the current role of chemotherapy in mCRPC patients and the right chemotherapy sequence of use of chemotherapy compared to new hormonal agents. Moreover, it would be important to address changes in the endpoints used in clinical trials, based on the stage of disease including the presence tumor-related symptoms, in order to identify the right therapeutic strategy.展开更多
文摘目的调查转移性去势抵抗性前列腺癌(metastatic castration resistant prostate cancer,mCRPC)化疗患者疾病应对方式特点和生存质量现状,探讨二者关系,为临床实践中改善mCRPC化疗患者疾病应对方式和生存质量提供依据。方法2019-01/2020-06月,采用便利抽样法选取兰州市3家三级甲等医院泌尿外科或肿瘤科接受化疗的391例mCRPC患者作为研究对象。利用患者一般人口学及疾病相关信息问卷、晚期患者生存质量量表(quality of life concerns in the end of life questionnaire,QOLC-E)及医学应对方式问卷进行调查。分析患者疾病应对方式、生存质量现状,同时分析应对方式与生存质量间的关系。结果mCRPC化疗患者生存质量总分为(2.92±0.38)分,mCRPC化疗患者生存质量与屈服、回避策略呈负相关(P<0.05),与面对应对策略呈正相关(P<0.01)。结论医护人员应指导患者建立积极的疾病应对态度,重视疾病应对方式对患者生存质量的影响,通过引导患者重塑积极的疾病应对方式来改善其生存质量。
文摘目的探讨益气散结法联合化疗治疗转移去势抵抗性前列腺癌(metastatic castration-resistantprostate cancer,mCRPC)的有效性及安全性。方法将32例mCRPC患者,1∶1随机分为益气散结法联合多西他赛化疗研究组和单纯多西他赛化疗组。根据前列腺癌工作组PCWG-2标准进行疗效评价,比较2组无疾病进展生存期(progress free survival,PFS)、PSA反应率,并进行安全性评价。采用FACT-P问卷调查患者生活质量情况。结果研究组的中位PFS略长于对照组(7.4 m vs 6.6 m),但无统计学差异(P>0.05)。4周期治疗后,2组PSA水平均较治疗前有显著下降(P<0.05)。益气散结法研究组PSA反应率64.29%,对照组38.46%。安全性方面,研究组中性粒细胞减少症、疲劳发生率显著低于对照组(P<0.05)。生活质量评分2组患者均有明显下降(P<0.05)。结论益气散结法联合多西他赛方案化疗能较好提高mCRPC患者的生活质量,降低化疗毒性,改善生存,但仍需大样本随机对照临床研究加以证实。
文摘Several recent studies in mCRPC have identified the mechanisms of tumoral growth after the disease becomes unresponsive to standard hormonal therapy. These studies have highlighted the importance of residual intratumoral androgens in maintaining androgen receptor (AR) transcriptional activity in mCRPC [1]. Based on this findings, it has been possible to develop drugs, blocking the key enzyme in the biosynthesis of androgens through the inhibition of cytochrome p450 17 (CYP17) such as Abiraterone Acetate (AA) and drugs which directly target the AR including Enzalutamide (E) and Orteronel. Before this new knowledge, mCRPC treatment benefited from chemotherapy with taxanes. Recently a new taxane, Cabazitaxel (C), was approved in second line setting in association with prednisone. Retrospective analyses have tried to clarify the current role of chemotherapy in mCRPC patients and the right chemotherapy sequence of use of chemotherapy compared to new hormonal agents. Moreover, it would be important to address changes in the endpoints used in clinical trials, based on the stage of disease including the presence tumor-related symptoms, in order to identify the right therapeutic strategy.
