上海交通大学学报(医学版) ›› 2017, Vol. 37 ›› Issue (11): 1483-.doi: 10.3969/j.issn.1674-8115.2017.11.006

• 论著(基础研究) • 上一篇    下一篇

阿比特龙联合泼尼松治疗转移性去势抵抗性前列腺癌的疗效及 预后因素分析#br#

樊连城 *,董柏君 *,迟辰斐,潘家骅,王艳青,邵晓光,徐凡,上官勋,周立新 #,薛蔚 #   

  1. 上海交通大学 医学院附属仁济医院泌尿科,上海  200127
  • 出版日期:2017-11-28 发布日期:2018-01-10
  • 通讯作者: 薛蔚(1970—),电子信箱:uroxuewei@163.com。周立新(1968—),电子信箱:zhou_li_xin@hotmail.com。# 共同通信作者
  • 作者简介:?樊连城(1993—),男,硕士生;电子信箱:787371380@qq.com。董柏君(1978—),男,主治医师,博士;电子信箱:787371380@qq.com。* 共同 第一作者
  • 基金资助:
    国家自然科学基金(81572536, 81672850);上海市浦东新区卫生系统重点学科群建设(PWZxq2014-05);上海市教育委员会高峰高原学科建设计 划(20152215)

Efficacy and prognostic factors of abiraterone combined with prednisone treating metastatic castration- resistant prostate cancer patients#br#

FAN Lian-cheng*, DONG Bai-jun*, CHI Chen-fei, PAN Jia-hua, WANG Yan-qing, SHAO Xiao-guang, XU Fan, SHANGGUAN Xun, ZHOU Li-xin#, XUE Wei#   

  1. Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Online:2017-11-28 Published:2018-01-10
  • Supported by:
    National Natural Science Foundation of China, 81572536, 81672850; Key Disciplines Group Construction Project of Pudong Health Bureau of Shanghai, PWZxq2014-05; Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support, 20152215

摘要:  目的 · 评价阿比特龙(AA)联合泼尼松治疗转移性去势抵抗性前列腺癌(mCRPC)患者的疗效,并分析预后因素。方法 · 回 顾性分析 2012 年 9 月—2016 年 12 月上海交通大学医学院附属仁济医院诊治的 112 例 mCRPC 患者的临床资料,其中 42 例先前接受 过化疗,70 例先前未接受过化疗。观察终点为前列腺特异性抗原无进展生存期(PSA PFS)、影像学无进展生存期(rPFS)以及总生 存期(OS)。采用Cox 单因素和多因素分析对患者PSA PFS、rPFS 以及OS 相关的预后因素进行分析。结果 · 中位随访时间 20.2 个 月,59 例患者死亡。中位 PSA PFS 8.9(7.8 ~ 10.0)个月,中位 rPFS 9.7(9.0 ~ 10.4)个月,中位 OS 22.2(20.3 ~ 24.1)个月。多 因素分析中,先前是否接受化疗、粒淋比(≥ 3 vs<3)、血清乳酸脱氢酶水平(≥ 196 U/L vs<196 U/L)、先前内分泌治疗有效时间 (<12 个月 vs ≥ 12 个月)、ECOG 评分(≤ 1 vs 2)与 mCRPC 患者接受 AA 联合泼尼松治疗的 PSA PFS 与 rPFS 显著相关,先前是否 接受化疗、ECOG PS (≤ 1 vs 2)与 OS 显著相关。结论 · AA 联合泼尼松治疗中国mCRPC 患者取得较好疗效,先前是否接受化疗、 ECOG PS(≤ 1 vs 2)与接受 AA 治疗的 mCRPC 患者 OS 显著相关。

关键词: 阿比特龙, 未经化疗, 转移性去势抵抗性前列腺癌, 疗效, 预后因素

Abstract: Objective · To assess the efficacy of abiraterone acetate (AA) plus prednisone treating metastatic castration-resistant prostate cancer (mCRPC) patients and analyze the prognostic factors for this treatment.  Methods · The medical history of 112 patients with mCRPC treated in Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine, including 70 patients in the chemotherapy-naive setting and 42 in the post-chemotherapy setting, were retrospectively reviewed. Coprimary end points were prostate specific antigen progression-free survival (PSA PFS), radiographic PFS (rPFS) and overall survival (OS). Univariable and multivariable Cox analyses were performed to determine prognostic factors that were associated with PSA PFS, rPFS and OS.  Results · At a median follow-up of 20.2 months, 59 (52.7%) patients had died. The median PSA PFS, rPFS and OS were 8.9 (7.8 ~ 10.0) months, 9.7 (9.0 ~ 10.4) months, and 22.2 (20.3 ~ 24.1) months, respectively. In multivariate analysis, previous chemotherapy, neutrophil lymphocyte ratio ( ≥ 3 vs<3), serum lactate dehydrogenase level ( ≥ 196 U/L vs<196 U/L) and ECOG PS ( ≤ 1 vs 2) were independent predictors for PSA PFS and rPFS, and previous chemotherapy, ECOG PS ( ≤ 1 vs 2) remained significant predictors for OS.  Conclusion · These results further support the favourable profile of AA plus prednisone in patients with mCRPC in China. Previous chemotherapy, ECOG PS ( ≤ 1 vs 2) remained significant predictors for OS.

Key words:  abiraterone acetate, chemotherapy naïve, metastatic castration-resistant prostate cancer, efficacy, prognostic factor