Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai, China.
Asian J Androl. 2012 May;14(3):505-8. doi: 10.1038/aja.2012.24. Epub 2012 Apr 16.
To identify the clinical features and independent predictors of survival in patients with bone metastases from prostate cancer (PCa). We retrospectively analysed 115 PCa patients with bone metastases between 1997 and 2009. The overall survival rate after bone metastases was calculated using the Kaplan-Meier method. The prognostic factors were identified by univariate analysis using a log-rank test and by multivariate analysis using Cox proportional hazards regression models. The follow-up rate was 100%, the follow-up cases during 1, 3 and 5 years were 103, 79 and 55, respectively. The 1-, 3- and 5-year survival rates were 89.1%, 60.9% and 49.8%, respectively, with a median survival time of 48.5 months for patients with bone metastases from PCa. In univariate analysis, age, Gleason score, clinical stage, the number of bone lesions, alkaline phosphatase (ALP) level, invasion of neighbouring organs and non-regional lymph node metastases were correlated with prognosis. By multivariate analysis using Cox regression, ALP level, Gleason score and non-regional lymph node metastases were independent prognostic factors. These prognostic factors will help us to determine the appropriate dose and fraction of radiotherapy for these patients.
明确前列腺癌(PCa)骨转移患者的临床特征和独立预后因素。
回顾性分析 1997 年至 2009 年间 115 例 PCa 骨转移患者。采用 Kaplan-Meier 法计算骨转移后总生存率。采用对数秩检验进行单因素分析,采用 Cox 比例风险回归模型进行多因素分析。
随访率为 100%,随访 1、3、5 年的病例数分别为 103、79、55 例。1、3、5 年生存率分别为 89.1%、60.9%、49.8%,中位生存时间为 48.5 个月。单因素分析显示,年龄、Gleason 评分、临床分期、骨转移灶数量、碱性磷酸酶(ALP)水平、邻近器官侵犯和非区域性淋巴结转移与预后相关。多因素 Cox 回归分析显示,ALP 水平、Gleason 评分和非区域性淋巴结转移是独立的预后因素。
这些预后因素有助于确定这些患者接受放疗的适宜剂量和分割方式。