Bamias Aristotle, Bozas George, Antoniou Nikolaos, Poulias Iraklis, Katsifotis Harilaos, Skolarikos Andreas, Mitropoulos Dionysios, Alamanis Christos, Alivizatos Gerassimos, Deliveliotis Haralambos, Dimopoulos Meletios A
Department of Clinical Therapeutics, University of Athens, School of Medicine, Athens, Greece.
Eur Urol. 2008 Feb;53(2):323-31. doi: 10.1016/j.eururo.2007.03.072. Epub 2007 Apr 5.
To investigate potential prognostic and predictive factors in patients with androgen-independent prostate cancer (AIPC) treated with docetaxel chemotherapy.
This analysis included 94 consecutive AIPC patients who were treated between March 2001 and May 2006 with biweekly docetaxel 45 mg/m(2) (day 2) and estramustine 140 mg three dimes daily (days 1-3).
Prostate-specific antigen (PSA) responses were observed in 45 of 84 evaluable patients (53%), whereas objective responses were observed in 16 of 40 patients with measurable disease (40%). Median survival (OS) was 16.2 mo (95% confidence interval [CI], 12.9-19.4) and median time to PSA progression (TTP) 5.0 mo (95%CI, 3.6-7.1). OS was independently associated with pain score baseline PSA and weight loss. Patients with only extraosseous disease had higher PSA response rate (87% vs. 49%, p=0.014) and superior TTP compared with patients with bone metastases with or without extraosseous disease (7.3 vs. 4.3 vs. 4 mo, p=0.002). Concurrent bone and extraosseous metastases were associated with worse prognosis compared with each site alone (median OS: 12.3 vs.19 vs.18.3 mo, p=0.007).
Among patients with AIPC treated with biweekly docetaxel and estramustine, baseline PSA >100, existence of pain, weight loss, and simultaneous extraosseous and bone disease were associated with worse prognosis. Extraosseous metastases seem to be more sensitive than bone disease to this chemotherapy.
探讨多西他赛化疗治疗雄激素非依赖性前列腺癌（AIPC）患者的潜在预后和预测因素。
本分析纳入了94例连续的AIPC患者，这些患者在2001年3月至2006年5月期间接受了每两周一次的多西他赛45mg/m²（第2天）和雌莫司汀140mg每日三次（第1 - 3天）的治疗。
84例可评估患者中有45例（53%）观察到前列腺特异性抗原（PSA）反应，而40例有可测量疾病的患者中有16例（40%）观察到客观反应。中位生存期（OS）为16.2个月（95%置信区间[CI]，12.9 - 19.4），PSA进展中位时间（TTP）为5.0个月（95%CI，3.6 - 7.1）。OS与疼痛评分、基线PSA和体重减轻独立相关。仅患有骨外疾病的患者与伴有或不伴有骨外疾病的骨转移患者相比，PSA反应率更高（87%对49%，p = 0.014），TTP更长（7.3对4.3对4个月，p = 0.002）。与单独每个部位相比，同时存在骨和骨外转移与更差的预后相关（中位OS：12.3对19对18.3个月，p = 0.007）。
在接受每两周一次多西他赛和雌莫司汀治疗的AIPC患者中，基线PSA>100、存在疼痛、体重减轻以及同时存在骨外和骨疾病与更差的预后相关。骨外转移似乎比骨疾病对这种化疗更敏感。
