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接受不同化学去势治疗的转移性前列腺癌患者中睾酮与前列腺特异性抗原动力学的相关性

Correlation Between Testosterone and PSA Kinetics in Metastatic Prostate Cancer Patients Treated With Diverse Chemical Castrations.

作者信息

Reis Leonardo O, Denardi Fernandes, Faria Eliney F, Silva Elcio Dias

机构信息

Pontifical Catholic University of Campinas, Campinas, Brazil University of Campinas-Unicamp, Campinas, Brazil

University of Campinas-Unicamp, Campinas, Brazil.

出版信息

Am J Mens Health. 2015 Sep;9(5):430-4. doi: 10.1177/1557988314552468. Epub 2014 Oct 7.

Abstract

To assess total testosterone and prostatic-specific antigen (PSA) kinetics among diverse chemical castrations, advanced-stage prostate cancer patients were randomized into three groups of 20: Group 1, Leuprolide 3.75 mg; Group 2, Leuprolide 7.5 mg; and Group 3, Goserelin 3.6 mg. All groups were treated with monthly application of the respective drugs. The patients' levels of serum total testosterone and PSA were evaluated at two time periods: before the treatment and 3 months after the treatment. Spearman's rank correlation coefficient was utilized to verify the hypothesis of linear correlation between total testosterone and PSA levels. At the beginning the patients' age, stage, grade, PSA, and total testosterone were similar within the three groups, with median age 72, 70, and 70 years in Groups 1, 2, and 3, respectively. Three months after the treatment, patients who received Leuprolide 7.5 mg presented significantly lower median total testosterone levels compared with Goserelin 3.6 mg and Leuprolide 3.75 mg (9.5 ng/dL vs. 20.0 ng/dL vs. 30.0 ng/dL, respectively; p = .0072), while those who received Goserelin 3.6 mg presented significantly lower PSA levels compared with Leuprolide 7.5 mg and Leuprolide 3.75 mg (0.67 vs. 1.86 vs. 2.57, respectively; p = .0067). There was no linear correlation between total testosterone and PSA levels. Overall, regarding castration levels of total testosterone, 28.77% of patients did not obtain levels ≤50 ng/dL and 47.80% did not obtain levels ≤20 ng/dL. There was no correlation between total testosterone and PSA kinetics and no equivalence among different pharmacological castrations.

摘要

为评估不同化学去势方法中总睾酮和前列腺特异性抗原(PSA)的动力学变化,晚期前列腺癌患者被随机分为三组,每组20人:第一组,亮丙瑞林3.75毫克;第二组,亮丙瑞林7.5毫克;第三组,戈舍瑞林3.6毫克。所有组均每月应用相应药物进行治疗。在两个时间段评估患者血清总睾酮和PSA水平:治疗前和治疗后3个月。采用Spearman等级相关系数来验证总睾酮和PSA水平之间线性相关的假设。开始时,三组患者的年龄、分期、分级、PSA和总睾酮水平相似,第一组、第二组和第三组的中位年龄分别为72岁、70岁和70岁。治疗3个月后,接受7.5毫克亮丙瑞林的患者中位总睾酮水平显著低于接受3.6毫克戈舍瑞林和3.75毫克亮丙瑞林的患者(分别为9.5纳克/分升、20.0纳克/分升和30.0纳克/分升;p = 0.0072),而接受3.6毫克戈舍瑞林的患者PSA水平显著低于接受7.5毫克亮丙瑞林和3.75毫克亮丙瑞林的患者(分别为0.67、1.86和2.57;p = 0.0067)。总睾酮和PSA水平之间不存在线性相关性。总体而言,就总睾酮的去势水平而言,28.77%的患者未达到≤50纳克/分升的水平,47.80%的患者未达到≤20纳克/分升的水平。总睾酮和PSA动力学之间无相关性,不同药物去势方法之间也不等效。

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