Ouzaid I, Rouprêt M
Service d'urologie et de transplantation rénale, hôpital de la Pitié-Salpêtrière, AP-HP, université Pierre-et-Marie-Curie, université Paris VI, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
Prog Urol. 2011 Nov;21(12):866-74. doi: 10.1016/j.purol.2011.07.006. Epub 2011 Sep 16.
Androgen-deprivation therapy modalities are on continuing evolution. Leuprolide Acetate (LA) Eligard(®)45mg was the first 6-monthly LHRH agonist (agoniste luteinizing hormone-releasing hormone [LHRHa]) treatment available for use in prostate cancer. The objective of this study was to assess the use of the 3-monthly and the 6-monthly LHRHa in patients with prostate cancer.
A two-step survey (registration and follow-up) was held between July 2008 and January 2009. One hundred and sixty doctors included patients treated with LHRHa for prostate cancer. Then, a follow-up registry was implemented for patients who had been prescribed a 3- or 6-monthly LHRHa.
Data analysis showed that the 1853 registered patients had a mean age of 75 years old. Time to diagnosis was 7 months. Among them, 26.4% had an N+ and/or M+ cancer. The most tumor node metastasis (TNM) stage represented was T3N0M0 with Gleason score 7. High prostate specific antigen (PSA) level and metastatic stage were the main motives for LHRHa prescription. Choice criteria for a 3 or a 6-monthly LHRHa were patient autonomy (3.2 vs 18.4%), age (27.2 vs 44%) and anxiety (28 vs 16.8%). Patients for 6-monthly LHRHa were likely to be with low urinary symptoms, older, less autonomous and less anxious. The reported advantage of the 3-monthly LHRHa was the high satisfying quality of medical follow-up. For the 6-monthly form, the advantages were the flexibility and the freedom to stop worrying about their cancer for up to 6 months.
The 6-monthly LHRHa provides more flexibility in the management and follow-up of patients with locally advanced or metastatic prostate cancer.
雄激素剥夺治疗方式在持续发展。醋酸亮丙瑞林(LA)缓释植入剂45mg是首个可用于前列腺癌治疗的每6个月一次的促黄体生成激素释放激素激动剂(LHRHa)。本研究的目的是评估每3个月一次和每6个月一次的LHRHa在前列腺癌患者中的应用情况。
在2008年7月至2009年1月期间进行了一项两步调查(登记和随访)。160名医生纳入了接受LHRHa治疗前列腺癌的患者。然后,对已开具每3个月或每6个月一次LHRHa处方的患者实施了随访登记。
数据分析显示,1853名登记患者的平均年龄为75岁。诊断时间为7个月。其中,26.4%患有N+和/或M+癌症。最常见的肿瘤淋巴结转移(TNM)分期为T3N0M0, Gleason评分7分。高前列腺特异性抗原(PSA)水平和转移分期是开具LHRHa处方的主要原因。选择每3个月或每6个月一次LHRHa的标准是患者自主性(3.2%对18.4%)、年龄(27.2%对44%)和焦虑程度(28%对16.8%)。接受每6个月一次LHRHa治疗的患者可能尿路症状较轻、年龄较大、自主性较差且焦虑程度较低。报告的每3个月一次LHRHa的优势是医疗随访的满意度高。对于每6个月一次的剂型,优势在于灵活性以及长达6个月无需担心癌症的自由。
每6个月一次的LHRHa在局部晚期或转移性前列腺癌患者的管理和随访中提供了更大的灵活性。