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日本前列腺癌内分泌治疗的现状:基于J-CaP收集的数据对原发性雄激素剥夺治疗的分析

Current status of endocrine therapy for prostate cancer in Japan analysis of primary androgen deprivation therapy on the basis of data collected by J-CaP.

作者信息

Hinotsu Shiro, Akaza Hideyuki, Usami Michiyuki, Ogawa Osamu, Kagawa Susumu, Kitamura Tadaichi, Tsukamoto Taiji, Naito Seiji, Namiki Mikio, Hirao Yoshihiko, Murai Masaru, Yamanaka Hidetoshi

机构信息

Urology and Andrology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba City, Ibaraki prefecture, 305-8575, Japan.

出版信息

Jpn J Clin Oncol. 2007 Oct;37(10):775-81. doi: 10.1093/jjco/hym098. Epub 2007 Oct 26.

Abstract

BACKGROUND

Based on the data of current status of endocrine therapy for prostate cancer registered in the Japan Study Group of Prostate Cancer (J-CaP), we conducted an analysis of primary androgen deprivation therapy (PADT) and an interim analysis of the prognosis.

METHODS

Of the 26 272 cases registered in the server of J-CaP, the 19 409 cases initially receiving PADT were included in this study. The initial therapy was divided into eight categories according to its features.

RESULTS

Of the 19 409 patients, 1513 (7.8%) were given anti-androgen monotherapy, 955 patients (4.9%) surgical castration only, 1001 patients (5.2%) surgical castration + anti-androgen, 3015 patients (15.5%) LHRH monotherapy, 1658 patients (8.5%) LH-RH + short-term anti-androgen, 10 434 patients (53.8%) LH-RH + anti-androgen, 37 patients (0.2%) watchful waiting and 796 patients (4.1%) other therapy. In progression-free survival, the prognosis was slightly better following maximum androgen blockade (MAB) in each stage.

CONCLUSIONS

The pattern of PADT is more typical in Japan compared with that in the United States. Patients who received MAB accounted for 59.0% of all the patients. MAB tends to be more often selected for patients who are rated as being at high risk on the basis of high Gleason score or PSA level upon diagnosis in each clinical stage of the disease. Investigations of the outcome are on-going and they will make clear the significance of this trend in Japan.

摘要

背景

基于日本前列腺癌研究组(J-CaP)登记的前列腺癌内分泌治疗现状数据,我们进行了一线雄激素剥夺治疗(PADT)分析及预后的中期分析。

方法

在J-CaP服务器登记的26272例病例中,本研究纳入了最初接受PADT的19409例病例。初始治疗根据其特点分为八类。

结果

在19409例患者中,1513例(7.8%)接受抗雄激素单药治疗,955例(4.9%)仅接受手术去势,1001例(5.2%)接受手术去势+抗雄激素治疗,3015例(15.5%)接受促性腺激素释放激素(LHRH)单药治疗,1658例(8.5%)接受LHRH+短期抗雄激素治疗,10434例(53.8%)接受LHRH+抗雄激素治疗,37例(0.2%)接受观察等待,796例(4.1%)接受其他治疗。在无进展生存期方面,各阶段最大雄激素阻断(MAB)后的预后略好。

结论

与美国相比,日本的PADT模式更为典型。接受MAB的患者占所有患者的59.0%。在疾病的每个临床阶段,根据诊断时高Gleason评分或前列腺特异抗原(PSA)水平被评定为高危的患者往往更常选择MAB。对结果的调查正在进行中,它们将明确这种趋势在日本的意义。

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