早期应用双磷酸盐在晚期前列腺癌治疗中的作用

The Role of Early Application of Bisphosphonates to the Treatment for Patients with Advanced Prostate Cancer

[目的]探讨早期静脉应用双磷酸盐对晚期前列腺癌进展及骨转移发生时间的影响。[方法]晚期前列腺癌患者48例,将骨密度T-Score≤-2.5作为双磷酸盐应用指征。在确诊骨转移之前即开始应用双磷酸盐定义为早期使用,归入治疗组(24例);在确诊骨转移之前未应用双磷酸盐者归入对照组(24例)。比较两组无进展生存期(PFS)、总生存期(OS)、骨转移发生率及发生时间。[结果]治疗组与照组相比较,中位PFS延长5个月(20个月vs 15个月),有统计学差异(χ2=114.03,P<0.001);中位OS较比对照组无明显延长(38个月vs 39个月,χ2=2.14,P=0.14)。治疗组骨转移发生率明显低于对照组(25.0%vs 62.5%,χ2=6.86,P<0.01)。治疗组平均确诊骨转移时间较对照组延迟4个月(21个月vs 17个月),差异有统计学意义(21±3.5个月vs 17±1.5个月,t=3.75,P<0.01)。[结论]早期应用双磷酸盐治疗晚期前列腺癌,可以明显延缓疾病进展,减少并推迟骨转移发生。

[Purpose] To investigate the effect of early application of bisphosphonates on and bone metastasis in patients with advanced prostate cancer. [Methods] Forty-eight cases with advanced prostate cancer were enrolled. The BMD T-Score ≤-2.5 was as indication of bisphosphonates application. The BPs application start before the diagnosis of bone metastases had defined as early application,24 cases included in the treatment group. Twenty-four patients those unused BPs before the diagnosis of bone metastases included in the control group. Progression-free survival（PFS）,overall survival（OS）,the incidence and the time of occurrence of bone metastases were compared between the two groups. [Results] The treatment group compared with the control group,the median PFS extended 5 months（20 months vs 15 months）,with significant difference（χ2=114.03,P〈0.001）;the median OS was not prolonged（38 months vs 39 months,χ2=2.14,P=0.14）;The incidence of bone metastases was significantly decreased（25.0% vs 62.5%,χ2=6.86,P〈0.01）;and the mean time of occurrence of bone metastases was delayed for 4 months（21 months vs 17 months）,with significant difference（21±3.5 months vs 17±1.5 months,t=3.75,P〈0.01）.[Conclusion] Early application of BPs in the treatment of patients with advanced prostate cancer can prolong PFS,delay and decrease bone metastatic occurrence.