D'Amico Anthony V, Kantoff Phillip, Loffredo Marian, Renshaw Andrew A, Loffredo Brittany, Chen Ming-Hui
Department of Radiation Oncology, Brigham and Women's Hospital and Dana Farber Cancer Institute, Boston, MA, USA.
Int J Radiat Oncol Biol Phys. 2006 Jul 1;65(3):656-60. doi: 10.1016/j.ijrobp.2006.01.053. Epub 2006 May 6.
We identified factors associated with the length of survival after prostate-specific antigen (PSA) failure.
The study cohort comprised 81 of 206 men enrolled on a randomized trial evaluating external-beam radiation therapy (RT) with or without androgen suppression therapy (AST) and who experienced PSA failure. Salvage AST was administered at a PSA level of approximately 10 ng/mL as per protocol. Cox regression was used to determine factors associated with length of survival after PSA failure.
A PSA DT (doubling time) <6 months (p = 0.04) and age at the time of PSA failure (p = 0.009) were significantly associated with length of survival. By 5 years, 35% and 65% of all-cause mortality was from prostate cancer in men whose age at PSA failure was 75 or higher vs. <75, respectively. Across all ages, 0%, 4%, as compared with 63% of men, were estimated to die of prostate cancer within 5 years after PSA failure if their PSA DT was >12, 6-12, or <6 months, respectively.
Advanced age and a PSA DT <6 months at the time of PSA failure are associated with a significantly shorter survival.
我们确定了与前列腺特异性抗原（PSA）失败后生存时间相关的因素。
研究队列包括206名参加评估外照射放疗（RT）联合或不联合雄激素抑制治疗（AST）的随机试验且经历PSA失败的男性中的81名。根据方案，在PSA水平约为10 ng/mL时给予挽救性AST。采用Cox回归确定与PSA失败后生存时间相关的因素。
PSA倍增时间（DT）<6个月（p = 0.04）和PSA失败时的年龄（p = 0.009）与生存时间显著相关。到5年时，PSA失败时年龄为75岁及以上与<75岁的男性中，分别有35%和65%的全因死亡是由前列腺癌导致的。在所有年龄组中，如果PSA DT>12个月、6 - 12个月或<6个月，估计在PSA失败后5年内死于前列腺癌的男性比例分别为0%、4%和63%。
PSA失败时年龄较大以及PSA DT<6个月与显著缩短的生存期相关。
