多西他赛再挑战治疗转移性去势抵抗性前列腺癌的效果及对患者预后的影响

Effect of docetaxel rechallenge in the treatment of metastatic castration-resistant prostate cancer and its impact on the prognosis of patients

目的探讨多西他赛再挑战治疗转移性去势抵抗性前列腺癌(mCRPC)的效果及对患者预后的影响。方法选取多西他赛一线治疗有效且进展后行多西他赛再挑战治疗的108例mCRPC患者。mCRPC患者多西他赛再挑战治疗后总生存期(OS)的影响因素采用多因素Logistic回归分析。结果108例mCRPC患者随访12~24个月,中位随访19.36个月,生存27例。第一序列多西他赛化疗与多西他赛再挑战治疗的治疗间歇期﹥6个月与≤6个月患者的中位前列腺特异性抗原(PSA)无进展生存期(PFS)分别为17.78个月(95%CI:13.22~22.34个月)、10.82个月(95%CI:8.39~13.25个月)。多因素Logistic回归模型分析结果显示,基线碱性磷酸酶(ALP)≥120 U/L、基线PSA≥60 ng/ml均是mCRPC患者多西他赛再挑战治疗后OS的独立危险因素(P﹤0.05)。结论多西他赛再挑战治疗mCRPC临床效果显著,基线ALP≥120 U/L、基线PSA≥60 ng/ml均是mCRPC患者多西他赛再挑战治疗后OS的独立危险因素,临床需早期识别存在危险因素的患者并采取相应措施以延长患者的OS。

Objective To investigate the effect of docetaxel rechallenge in the treatment of metastatic castration-resistant prostate cancer(mCRPC)and its impact on the prognosis of patients.Method A total of 108 patients with mCRPC who responded to first-line docetaxel treatment and those who underwent docetaxel rechallenge treatment after progression was selected.Multivariate Logistic regression analysis was used to analyze the risk factors for overall survival(OS)in mCRPC patients after docetaxel rechallenge therapy.Result A total of 108 mCRPC patients were followed up for 12-24 months,with a median follow-up of 19.36 months,and 27 patients survived at the end of the point.The median prostate specific antigen(PSA)progression-free survival(PFS)for patients with treatment interval>6 months and≤6 months between first-sequence docetaxel chemotherapy and docetaxel rechallenge was 17.78 months(95%CI:13.22-22.34 months)and 10.82 months(95%CI:8.39-13.25 months),respectively.Multivariate Logistic regression model analysis showed that baseline alkaline phosphatase(ALP)≥120 U/L and baseline PSA≥60 ng/ml were independent risk factors for OS after docetaxel rechallenge in mCRPC patients(P<0.05).Conclusion The clinical effects of docetaxel rechallenge in mCRPC is significant that baseline ALP≥120 U/L and baseline PSA≥60 ng/ml were independent risk factors for OS after docetaxel rechallenge in mCRPC patients.Those patients with risk factors need to be identified early in clinical practice,and corresponding measures should be taken to prolong the patient’s OS.