摘要
目的探讨阿比特龙联合泼尼松治疗雄激素剥夺治疗失败后转移性去势抵抗性前列腺癌的可行性。方法选择我院2015年8月至2017年1月收治的148例雄激素剥夺治疗失败后转移性去势抵抗性前列腺癌患者作为研究对象,采用随机数字表法分为对照组(85例)和观察组(63例),对照组采取多西他赛联合泼尼松治疗,观察组采取阿比特龙联合泼尼松治疗。以总体生存期为主要研究终点指标,以前列腺特异性抗原(PSA)无进展生存期、影像学无进展生存期为次要研究终点指标。比较两组PSA反应率、骨痛缓解率、治疗前后的晚期前列腺癌患者生活质量量表(FACT-P)评分及不良反应发生情况。结果在入组患者中,对照组79例,观察组60例,均获得随访,随访6~38个月,中位随访时间17.0个月;观察组中位总体生存期、中位PSA无进展生存期、中位影像学无进展生存期均明显长于对照组,差异均有统计学意义(P<0.05);观察组PSA反应率、骨痛缓解率及治疗后的FACT-P评分均明显高于对照组,差异均有统计学意义(P<0.05);观察组Ⅲ~Ⅳ级不良反应发生率为6.67%,明显低于对照组的35.44%,差异有统计学意义(P<0.05)。结论阿比特龙联合泼尼松治疗能有效抑制雄激素剥夺治疗失败后转移性去势抵抗性前列腺癌的进展,使患者在延长总体生存期、降低PSA水平、缓解骨痛和改善生活质量上明显获益,且治疗耐受性良好,值得进一步研究应用。
Objective To investigate the feasibility of abiraterone combined with prednisone in the treatment of metastatic castration-resistant prostate cancer after failure of androgen deprivation therapy.Methods Totally 148 patients with metastatic castration-resistant prostate cancer who were treated with androgen deprivation therapy from August 2015 to January 2017 were selected as subjects,the patients were divided into control group(n=85)and observation group(n=63)by random number table method.Control group was treated with docetaxel plus prednisone;The observation group was treated with abiraterone combined with prednisone.The overall survival time was the primary endpoint of the study,with prostate-specific antigen(PSA)progression-free survival and imaging progression-free survival as secondary endpoints.The PSA response rate,bone pain relief rate,the quality of life(FACT-P) scores before and after treatment and adverse reactions of patients with advanced prostate cancer were compared between the two groups.Results Among the enrolled patients,79 patients in control group and 60 patients in observation group were followed up for 6~38 months,median follow-up time being 17.0 months;the median overall survival,median PSA progression-free survival,and median imaging progression-free survival were significantly longer in observation group than in control group,and the differences were statistically significant(P<0.05);the PSA response rate,bone pain relief rate and FACT-P score after treatment were significantly higher in observation group than in control group,and the difference being statistically significant(P<0.05);the incidence of grade Ⅲ~Ⅳ adverse reactions in observation group was 6.67%,which was significantly lower than 35.44%in control group,the difference being statistically significant(P<0.05).Conclusion Abiraterone combined with prednisone treatment can effectively inhibit the progression of metastatic castration-resistant prostate cancer after failure of androgen deprivation therapy;the patients benefit from a prolonged overall survival,reduced PSA levels,relief of bone pain and improved quality of life.The treatment is well-tolerated and worthy of further research and application.
作者
王业强
秦勇
刘渊
顾海
WANG Ye-qiang;QIN Yong;LIU Yuan;GU Hai(Department of Urology,Hangzhou Red Cross Hospital, Hangzhou 310003,China)
出处
《实用药物与临床》
CAS
2019年第9期937-942,共6页
Practical Pharmacy and Clinical Remedies
关键词
去势抵抗性前列腺癌
阿比特龙
泼尼松
雄激素
Castration-resistant prostate cancer
Abiraterone
Prednisone
Androgen
