Clin Nucl Med. 2018 Jan;43(1):9-16. doi: 10.1097/RLU.0000000000001904.
To identify pre-therapeutic variables associated with overall survival (OS) in patients treated with Ra.
Data from 45 CRPC patients treated with Ra were retrospectively analyzed. All patients who received at least one Ra injection were included in the study. Cox proportional hazard regression models were used to estimate hazard ratio's (HR) and to test for association.
Twenty-one patients (47%) received six Ra injections and 24 patients (53%) received one to five Ra injections. Median OS since start of Ra was 13.0 months (95% confidence interval (CI) 8.2-17.8). Patients who completed Ra therapy had a median OS of 19.7 months (95% CI 14.9-24.6), while patients who received one to five Ra injections had a median OS of 5.9 months (95% CI 3.8-8.1; P < 0.001).Univariable analysis showed poor baseline ECOG performance status (PS), baseline opioid use, lowered baseline hemoglobin, and elevated prostate-specific antigen, alkaline phosphatase and lactate dehydrogenase (LD) levels were significantly associated with OS. Multivariable Cox regression analysis demonstrated that poor baseline ECOG PS (HR 10.6) and high LD levels (HR 7.7) were pre-therapeutic variables that predicted poor OS.
In a multivariable Cox regression model, good baseline ECOG PS and low LD levels were significantly associated with longer OS in patients treated with Ra. These variables may be used for stratification of CRPC patients for Ra therapy. Prospective studies to evaluate these variables are warranted, to develop a nomogram to select patients properly. In this retrospective study, predictors of overall survival in 45 metastatic castration-resistant prostate cancer patients treated with Ra therapy were evaluated. Baseline ECOG performance status and lactate dehydrogenase levels turned out to be significant in a multivariable prediction model for overall survival.
确定接受镭治疗的患者的总生存期（OS）的治疗前变量。
回顾性分析 45 例接受镭治疗的 CRPC 患者的数据。所有接受至少一次镭注射的患者均纳入研究。使用 Cox 比例风险回归模型来估计风险比（HR）并进行关联检验。
21 例（47%）患者接受了 6 次镭治疗，24 例（53%）患者接受了 1 至 5 次镭治疗。自镭治疗开始以来的中位 OS 为 13.0 个月（95%置信区间[CI] 8.2-17.8）。完成镭治疗的患者中位 OS 为 19.7 个月（95%CI 14.9-24.6），而接受 1 至 5 次镭治疗的患者中位 OS 为 5.9 个月（95%CI 3.8-8.1；P<0.001）。单变量分析显示基线 ECOG 表现状态（PS）差、基线使用阿片类药物、基线血红蛋白降低以及前列腺特异性抗原、碱性磷酸酶和乳酸脱氢酶（LD）水平升高与 OS 显著相关。多变量 Cox 回归分析表明，基线 ECOG PS 差（HR 10.6）和 LD 水平高（HR 7.7）是预测 OS 不良的治疗前变量。
在多变量 Cox 回归模型中，基线 ECOG PS 良好和 LD 水平低与接受镭治疗的患者的 OS 延长显著相关。这些变量可用于对接受镭治疗的 CRPC 患者进行分层。需要进行前瞻性研究来评估这些变量，以制定适当选择患者的列线图。在这项回顾性研究中，评估了接受镭治疗的 45 例转移性去势抵抗性前列腺癌患者的总生存预测因子。在多变量预测模型中，基线 ECOG 表现状态和乳酸脱氢酶水平对总生存具有显著意义。
