Nayyar Rishi, Sharma Nitin, Gupta Narmada P
Department of Urology, All India Institute of Medical Sciences, New Delhi, India.
Int J Urol. 2009 Sep;16(9):726-31. doi: 10.1111/j.1442-2042.2009.02351.x.
To evaluate the efficacy of docetaxel/prednisone and zoledronic acid in hormone refractory prostate cancer (HRPC) patients and to analyze prognostic factors predicting overall survival.
Forty-four HRPC patients were given docetaxel (75 mg/m(2)), prednisone and zoledronic acid (4 mg) every three weeks. Overall and progression-free survival curves were calculated. Using the log-rank test, variables predicting overall survival (age, Gleason score, baseline prostate-specific antigen [PSA], percentage PSA decline, nadir PSA, number of chemotherapy cycles) were calculated.
Median age was 66 years and mean PSA 171.25 ng/mL. The average number of given cycles was 6.3. A good PSA response (>50% decline) was observed in 26/44 cases (59.1%). A total of 17/44 (38.6%) patients expired with a median overall survival of 62.4 weeks. Patients with a Gleason score less than 7, who received more than four cycles and with a more-than-50% decline in PSA had significantly better survival. Variables like age, baseline PSA and nadir PSA did not significantly affect survival.
The combination of docetaxel/zoledronic/prednisone is safe and effective in the management of HRPC. Patients with a Gleason score <7, PSA decline >50% and those who receive more than four cycles have significantly better survival.
评估多西他赛/泼尼松和唑来膦酸对激素难治性前列腺癌（HRPC）患者的疗效，并分析预测总生存期的预后因素。
44例HRPC患者每三周接受多西他赛（75mg/m²）、泼尼松和唑来膦酸（4mg）治疗。计算总生存期和无进展生存期曲线。使用对数秩检验计算预测总生存期的变量（年龄、Gleason评分、基线前列腺特异性抗原[PSA]、PSA下降百分比、最低PSA、化疗周期数）。
中位年龄为66岁，平均PSA为171.25ng/mL。平均给药周期数为6.3个。26/44例（59.1%）观察到良好的PSA反应（下降>50%）。共有17/44例（38.6%）患者死亡，中位总生存期为62.4周。Gleason评分小于7、接受超过四个周期治疗且PSA下降超过50%的患者生存期明显更长。年龄、基线PSA和最低PSA等变量对生存期无显著影响。
多西他赛/唑来膦酸/泼尼松联合用药治疗HRPC安全有效。Gleason评分<7、PSA下降>50%且接受超过四个周期治疗的患者生存期明显更长。
