阿比特龙联合泼尼松治疗晚期转移性去势抵抗性前列腺癌的疗效观察

目的探讨阿比特龙联合泼尼松治疗晚期转移性去势抵抗性前列腺癌(mCRPC)的临床疗效及安全性。方法119例晚期mCRPC患者按照随机数字表法分为观察组(54例)和对照组(65例)。观察组采用阿比特龙+泼尼松治疗,对照组采用多西他赛+泼尼松治疗。观察比较两组的临床疗效、不良反应发生情况以及前列腺特异性抗原无进展生存期(PSAPFS)、影像学无进展生存期(rPFS)、总体生存期(OS)。结果共有6例患者未完成总评估与随访,中位随访时间为19.4(13.8,23.7)个月。观察组患者的治疗总有效率为22.22%、疾病控制率为64.82%,对照组的总有效率为6.15%、疾病控制率为21.54%,两组比较差异有统计学意义(P<0.01)。观察组患者的前列腺特异性抗原无进展生存期(PSAPFS)、影像学无进展生存期(rPFS)和总体生存期(OS)时间均长于对照组,差异有统计学意义(P<0.01)。观察组Ⅲ〜Ⅳ级不良反应的发生率明显低于对照组,差异有统计学意义(P<0.05)。结论阿比特龙联合泼尼松治疗晚期转移性去势抵抗性前列腺癌的临床疗效较好,OS明显延长且不良反应少,值得临床推广。

Objective To explore the clinical efficacy and safety of abiraterone combined with prednisone in the treatment of advanced metastatic castration-resistant prostate cancer(mCRPC).Methods According to the random number table method,119 patients with advanced mCRPC were divided into observation group(54 cases)and control group(65 cases).The observation group was treated with abiraterone+prednisone,and the control group was treated with docetaxel+prednisone.The clinical efficacy,adverse reactions,prostate-specific antigen progression-free survival,imaging progression-free survival,and overall survival were observed and compared between the two groups.Results A total of 6 patients did not complete the total assessment and follow-up,and the median follow-up time was 19.4(13.8,23.7)months.The total effective rate of treatment in the observation group was 22.22%,and the disease control rate was 64.82%.The total effective rate in the control group was 6.15%and the disease control rate was 21.54%.The difference between the two groups was statistically significant(P<0.01).The prostate-specific antigen progression-free survival(PSA PFS),imaging progression-free survival(rPFS)and overall survival(OS)of the observation group were longer than those of the control group,and the difference was statistically significant(P<0.01).The incidence of gradeⅢtoⅣadverse reactions in the observarion group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Abiraterone combined with prednisone has a better clinical effect in the treatment of advanced metastatic castrarion-resistant prostate cancer,with significantly prolonged OS and fewer adverse reactions,which is worthy of clinical promotion.