多西他赛联合贝伐单抗治疗激素难治性前列腺癌临床疗效

Clinical efficacy of combined use of docetaxel and bevacizumab in treating hormone refractory prostate cancer

目的研究多西他赛联合贝伐单抗对激素难治性前列腺癌(hormone refractory prostate cancer,HRPC)的临床疗效。方法选取2011年4月—2013年4月在我院就诊的HRPC 74例,最小随机化法分为化疗组和联合治疗组,每组37例;化疗组采用多西他赛联合泼尼松治疗方案,联合治疗组在化疗组用药基础上加用贝伐单抗(5 mg/kg)。观察无病生存时间、总生存时间、血清前列腺特异性抗原(prostate specific antigen,PSA)、前列腺体积、最大尿流率、生活质量。结果治疗后,联合治疗组中位无病生存时间10个月、中位总生存时间22个月高于化疗组的7个月和17个月(P<0.05),联合治疗组PSA值低于化疗组,联合治疗组游离PSA/总PSA高于化疗组(P<0.05),2组比较前列腺体积、最大尿流率变化及生活质量评分差异均无统计学意义(P>0.05),联合治疗组不良反应发生率64.86%高于化疗组的48.65%(P<0.05)。结论联合应用贝伐单抗可以延长患者生存时间,但其他疗效仍需进一步研究。随着HRPC转化医学研究的深入,免疫治疗、靶向治疗、个体化治疗及药物联合应用必将成为HRPC研究热点。

Objective To evaluate the efficacy of docetaxel combined with bevacizumab in treating hormone refractory prostate cancer(HRPC).Methods A total of 74 HRPC patients were selected in Navy General Hospital from Apr 2011 to Apr 2013.Seventy-four patients were randomly divided into two groups: chemotherapy group(docetaxel,40 mg/m 2 ) and combined treatment group (docetaxel combined with bevacizumab ,5 mg/kg).A total of 74 subjects were evaluated by the di -sease free survival time,the overall survival time,prostate specific antigen (PSA),the volume of the prostate,the maximal urinary flow rate and the score of Quality of Life .Results The disease free survival time(10 months) and the overall survival time (22 months) on combined treatment group were both longer than chemotherapy group (7 months and 17 months, P<0.05).After treatment, the value of PSA of combined treatment group was lower than that of chemotherapy group (P<0.05). There were no significant difference between the the volume of the prostate ,the maximal urinary flow rate and the score of Quality of Life in two groups (P>0.05).The adverse reaction rate of combined treatment group (64.86%) was higher than that of the chemotherapy group (48.65%, P<0.05). Conclusion The combined application of bevacizumab can prolong the survival time , but the other efficacy still needs further study.With the in-depth application of HRPC translational medicine , immune therapy, targeted therapy and individual therapy will become hot topic of HRPC treatment .