间歇性多西他赛联合泼尼松治疗去势抵抗性前列腺癌初步研究

Intermittent Docetaxel Plus Prednisone in Patients with Castration Resistant Prostate Cancer:A Pilot Study

目的评估间歇性多西他赛联合泼尼松方案治疗去势抵抗性前列腺癌的有效性及生活质量。方法回顾性分析十堰市人民医院2008年2月至2011年12月收治的42例去势抵抗性前列腺癌患者临床资料,根据不同治疗方案分为间歇性化疗组(20例)接受3周1次多西他赛加泼尼松治疗,当血清总前列腺特异性抗原(PSA)下降>50%并伴随稳定影像学证据时给予患者化疗休息期(停用多西他赛),一旦出现PSA增高>25%或出现其他疾病进展的依据时化疗休息期中止,再次给予多西他赛化疗,当达到上述标准时化疗休息期不限。持续性化疗组(22例)持续接受3周1次多西他赛10个循环。评估两组患者PSA无进展生存时间、总生存时间及生活质量。结果间歇性化疗组中位PSA无进展时间(9 months vs 10 months)及总体生存时间(20 months vs 23 months)与持续性化疗组比较无统计学意义(P>0.05)。间歇性化疗组患者化疗后显著改善总体健康状态及疲劳(P<0.05),持续性化疗组患者化疗后显著增加了消化道反应及疲劳症状评分(P<0.05)。结论间歇性3周1次多西他赛联合泼尼松治疗去势抵抗性前列腺癌是有效的,可能有更好的生活质量。

Objective To evaluate the efficacy and quality of life of intermittent docetaxel with prednisone in patients with castration resistant prostate cancer（CRPC）.Methods A retrospective controlled study of 42 patients with CRPC from Shiyan People＇s Hospital during Feb.2008 and Dee.2011 was done.Group A （n =20）,comprised patients having received intravenous docetaxel once tri-weekly plus prednisone.The patients entered the docetaxel holiday when a 〉 50% prostate-specific antigen（PSA） decline associated with stable radiographic scans.Docetaxel was restarted in the case of a PSA level rise 〉25% or until there was any other evidence of disease progression.The chemotherapy holiday was not limited when the patient＇s condition was within the reference values.Group B （n =22） included patients continuously administering once tri-weekly docetaxel for 10 cycles.The PSA progression-free survival,overall survival and quality of life of the two groups were evaluated.Results There were no statistically significant difference in PSA progression-free survival（9 months vs 10 months） and overall survival（20 months vs 23 months） between groups A and B.A significant improvement in the score of overall health and fatigue for group A were recorded in post chemotherapy compared to pre-chemotherapy （P 〈 0.05）.However,the score of symptom reports （fatigue,nausea/vomits） on group B were observed a significant rise in post-chemotherapy than those in pre-chemotherapy （P 〈 0.05）.Condusion Intermittent tri-weekly docetsxel with prednisone is clinically effective and may result in better quality of life for patients with CRPC.