Shiota Masaki, Yokomizo Akira, Takeuchi Ario, Kiyoshima Keijiro, Inokuchi Junichi, Tatsugami Katsunori, Shiga Ken-Ichiro, Koga Hirofumi, Yamaguchi Akito, Naito Seiji, Eto Masatoshi
Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Division of Urology, Harasanshin Hospital, Fukuoka, Japan.
BJU Int. 2016 Dec;118(6):880-884. doi: 10.1111/bju.13483. Epub 2016 Apr 6.
To investigate the potential relationship of steroid usage with prostate-specific antigen (PSA) flare as well as the prognostic impact of PSA flare, which is known to occur in 10-20% of patients with metastatic castration-resistant prostate cancer during docetaxel chemotherapy.
This study included 71 patients with metastatic castration-resistant prostate cancer treated by docetaxel chemotherapy with co-introduction of a steroid. PSA flare was defined as a transient PSA increase followed by a PSA decrease.
PSA flare was recognized in 7.0-23.9% of patients according to the definition used. Intriguingly, men with steroid intake before the initiation of docetaxel chemotherapy experienced significantly fewer PSA flares. The progression-free survival rate in men with PSA flare was equivalent to that of PSA responders, but significantly better than men with PSA failure.
Our results suggest that de novo steroid co-introduction with docetaxel chemotherapy induces the PSA flare phenomenon. This novel finding may account for the mechanism of PSA flare as well as being valuable for distinguishing PSA elevation attributable to PSA flare from that attributable to PSA failure.
探讨类固醇使用与前列腺特异性抗原（PSA）激增之间的潜在关系，以及PSA激增的预后影响。已知在多西他赛化疗期间，10%-20%的转移性去势抵抗性前列腺癌患者会出现PSA激增。
本研究纳入了71例接受多西他赛化疗并同时引入类固醇的转移性去势抵抗性前列腺癌患者。PSA激增定义为PSA短暂升高后下降。
根据所使用的定义，7.0%-23.9%的患者出现了PSA激增。有趣的是，在多西他赛化疗开始前摄入类固醇的男性经历的PSA激增明显较少。出现PSA激增的男性的无进展生存率与PSA反应者相当，但明显优于PSA无反应者。
我们的结果表明，多西他赛化疗同时引入类固醇会引发PSA激增现象。这一新发现可能解释了PSA激增的机制，并且对于区分由PSA激增引起的PSA升高和由PSA无反应引起的PSA升高具有重要价值。
Zotero 插件