摘要
目的评估醋酸阿比特龙加泼尼松治疗高危转移性激素敏感性前列腺癌(mHSPC)的安全性及疗效。方法通过医院信息检索系统,收集2019年1月至2020年3月由武汉大学人民医院收治的高危mHSPC患者资料。观察高危mHSPC患者在醋酸戈舍瑞林联合醋酸阿比特龙加泼尼松治疗后,血清前列腺特异性抗原(PSA)及睾酮水平变化、疾病进展时间、不良反应及生活质量。选取本院同期使用醋酸戈舍瑞林联合比卡鲁胺的mHSPC患者作为对照。结果(1)收集符合标准的患者共116例,阿比特龙组76例,比卡鲁胺组40例,两组基线水平一致(P>0.05);(2)3、6、12个月后,阿比特龙组的PSA分别为[2.65(2.55,2.99)]ng/ml、[0.47(0.45,0.53)]ng/ml和[0.02(0.02,0.92)]ng/ml,低于比卡鲁胺组的[24.13(22.48,24.34)]ng/ml、[8.38(7.81,8.46)]ng/ml和[1.67(1.56,1.69)]ng/ml,差异有统计学意义(P<0.05);阿比特龙组的睾酮平均值分别为(8.21±5.66)ng/dl、(7.68±2.92)ng/dl和(7.17±1.49)ng/dl,低于比卡鲁胺组的(38.82±13.19)ng/dl、(24.85±2.57)ng/dl和(10.70±2.08)ng/dl,差异有统计学意义(P<0.05);(3)阿比特龙组和比卡鲁胺组的12个月未进展生存率分别为100%和87.50%,差异有统计学意义(P<0.05);(4)两组患者的不良反应总发生率分别为15.7%和17.5%,差异无统计学意义(P>0.05);(5)治疗6个月后的两组患者的生活质量评分中,尿失禁评分(漏尿频率及控制情况)和排便评分(包括排便急迫感、排便次数、腹部和直肠疼痛等)均高于同组治疗前,差异均有统计学意义(P<0.05)。结论醋酸戈舍瑞林联合阿比特龙加泼尼松治疗高危mHSPC患者3、6、12个月后PSA分别降低98.3%、99.7%和99.8%,且睾酮能控制在去势水平,12个月治疗期间未进展为去势抵抗性前列腺癌,不良反应总体可控且能明显改善患者的生活质量。
Objective To evaluate the safety and efficacy of Abiraterone acetate plus Prednisone in the treatment of metastatic hormone-sensitive prostate cancer(mHSPC).MethodsData of highrisk mHSPC patients admitted to Renmin Hospital of Wuhan University from January 2019 to March 2020 were collected through the hospital information retrieval system.Observe the changes of serum prostatespecific antigen(PSA)and testosterone levels,time to disease progression,adverse reactions and quality of life in high-risk mHSPC patients treated with Goserelin combined with Abiraterone acetate and Prednisone.mHSPC patients treated with Goserelin combined with Bicalutamide during the same period in our hospital were selected as controls.Results(1)A total of 116 patients meeting the criteria were collected,including 76 patients in the Abiraterone group and 40 patients in the Bicalutamide group.The baseline level of the two groups was consistent(P>0.05).(2)After 3,6 and 12 months,the mean PSA values of Abiraterone group were[2.65(2.55,2.99)]ng/ml,[0.47(0.45,0.53)]ng/ml and[0.02(0.02,0.92)]ng/ml,respectively,[24.13(22.48,24.34)]ng/ml,[8.38(7.81,8.46)]ng/ml and[1.67(1.56,1.69)]ng/ml in the Bicarumide group,and the difference was statistically significant(P<0.05).Mean testosterone levels in the Abiraterone group were(8.21±5.66)ng/dl,(7.68±2.92)ng/dl,and(7.17±1.49)ng/dl,respectively,lower than(38.82±13.19)ng/dl,(24.85±2.57)ng/dl and(10.70±2.08)ng/dl in the Bicarumide group,and the difference was statistically significant(P<0.05).(3)The 12-month progression-free survival rates of Abiraterone group and Bicalutamide group was 100%and 87.50%,respectively,and the difference was statistically significant(P<0.05).(4)The total incidence of adverse reactions in two groups was 15.7%and 17.5%,respectively,and there was no statistical difference(P>0.05).(5)After 6 months of treatment,urinary incontinence score(frequency and control of urine leakage)and defecation score(including urgency of defecation,frequency of defecation,abdominal and rectal pain,etc.)in two groups were higher than those before treatment,with statistical difference(P<0.05).ConclusionsIn high-risk mHSPC patients treated with Goserrelin in combination with Abiraterone and Prednisone,PSA decreased by 98.3%,99.7%and 99.8%respectively at 3,6,and 12 months,and castration-resistant prostate cancer testosterone levels were controlled at castration levels without progression to castration-resistant prostate cancer(CRPC)during the 12 months of treatment.The adverse reactions were generally controllable and the quality of life of the patients was significantly improved.
作者
柯帅
刘泽林
翟官忠
王清华
郭佳
Ke Shuai;Liu Zelin;Zhai Guanzhong;Wang Qinghua;Guo Jia(Department of Urology,Renmin Hospital of Wuhan University,Wuhan430060,China)
出处
《中华腔镜泌尿外科杂志(电子版)》
2022年第6期508-512,共5页
Chinese Journal of Endourology(Electronic Edition)
基金
国家自然科学基金青年基金(81702539)。
关键词
激素敏感性前列腺癌
阿比特龙
比卡鲁胺
回顾性分析
Hormone-sensitive prostate cancer
Abiraterone
Bicalutamide
Retrospective analysis