• 医学文献
  • 知识库
  • 评价分析
  • 全部
  • 中外期刊
  • 学位
  • 会议
  • 专利
  • 成果
  • 标准
  • 法规
  • 临床诊疗知识库
  • 中医药知识库
  • 机构
  • 作者
热搜词:
换一批
论文 期刊
取消
高级检索

检索历史 清除

医学文献 >>
  • 全部
  • 中外期刊
  • 学位
  • 会议
  • 专利
  • 成果
  • 标准
  • 法规
知识库 >>
  • 临床诊疗知识库
  • 中医药知识库
评价分析 >>
  • 机构
  • 作者
热搜词:
换一批

多西他赛化疗联合内分泌治疗对转移性激素敏感性前列腺癌的有效性及安全性分析

Docetaxel chemotherapy combined with androgen-deprivation therapy in metastatic hormone-sensitive prostate cancer: an efficacy and safety analysis

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).在治疗耐受性方面,联合化疗组27.9%(17/61)的患者出现3~4级中性粒细胞减少,24.6%(15/61)的患者存在皮肤黏膜损害,13.1% (8/61)的患者出现肝功能不全,9.8%(6/61)的患者出现周围神经毒性.联合化疗组和单纯内分泌治疗组内分泌治疗相关男性乳房发育的发生率分别为14.8% (9/61)和16.3%(21/131),勃起功能障碍的发生率均为100%,两组差异均无统计学意义(P>0.05).结论 对于转移性激素敏感性前列腺癌,多西他赛化疗联合内分泌治疗可延长患者的无进展生存期,延长去势抵抗的时间,且治疗过程中不良反应安全可控.

更多
abstracts:

Objective To investigate the efficacy and safety of docetaxel chemotherapy combined with androgen-deprivation therapy (ADT) for patients with metastatic hormone-sensitive prostate cancer.Methods One 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.Results One hundred and ninety-two patients were regularly followedup.The median follow-up time was 23.3 (14.4-33.4) months.Median progression free survival time of combination therapy group and single treatment group were respectively 24.4 (7.5-31.3) months vs.17.5(3.0-30.7) months (P < 0.001).There were 1 and 16 cases died in the two groups due to disease progression.During the treatment,the rate of PSA level less than 0.2 ng/ml was 29.5% (18/61) vs.13.7% (18/131) in combination therapy group and single treatment group.Regarding the tolerance of combination therapy group,the incidence rate of grade 3-4 neutropenia was 27.9% (17/61).Skin and mucous membrane damaged in 24.6% (15/61) patients,transaminase rised in 13.1% (8/61) patients,and peripheral nerve toxicity occurred in 9.8% (6/61) patients.There was no significant difference between the 2 groups in relevant events caused by ADT,gynecomastia (14.8% vs.16.3%) and erectile dysfunction (100% vs.100%).Most of them could be relieved by symptomatic treatment.Conclusions For metastatic hormone-sensitive prostate cancer,docetaxel combined with hormonal treatment showed longer progression free survival than ADT alone with adverse reactions acceptable.

More
  • 浏览:406
  • 下载:396

加载中!

相似文献

  • 中文期刊
  • 外文期刊
  • 学位论文
  • 会议论文

加载中!

加载中!

加载中!

加载中!

扩展文献

特别提示:本网站仅提供医学学术资源服务,不销售任何药品和器械,有关药品和器械的销售信息,请查阅其他网站。

  • 客服热线:4000-115-888 转3 (周一至周五:8:00至17:00)

  • |
  • 客服邮箱:yiyao@wanfangdata.com.cn

  • 违法和不良信息举报电话:4000-115-888,举报邮箱:problem@wanfangdata.com.cn,举报专区

官方微信
万方医学小程序
new翻译 充值 订阅 收藏 移动端

官方微信

万方医学小程序

使用
帮助
Alternate Text
调查问卷