化疗引起的中性粒细胞减少症与一线多西他赛治疗转移性去势抵抗性前列腺癌患者的结局
Chemotherapy-Induced Neutropenia and Outcome in Patients With Metastatic Castration-Resistant Prostate Cancer Treated With First-Line Docetaxel.
机构信息
Division of Medical Oncology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy.
Division of Medical Oncology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy.
出版信息
Clin Genitourin Cancer. 2018 Aug;16(4):318-324. doi: 10.1016/j.clgc.2018.05.006. Epub 2018 Jun 1.
BACKGROUND
Neutropenia is a common side effect associated with docetaxel use. We retrospectively investigated the association between chemotherapy-induced neutropenia and survival in metastatic castration-resistant prostate cancer (mCRPC) patients receiving first-line docetaxel.
PATIENTS AND METHODS
Metastatic castration-resistant prostate cancer patients treated with first-line docetaxel, with known neutrophils value 10 days after first administration, were included in this retrospective analysis. Neutropenia was categorized in Grade 0 to 1 (G0-1), Grade 2 to 3 (G2-3), and Grade 4 (G4). Outcome measures were progression-free survival (PFS) and overall survival (OS).
RESULTS
Eighty patients were analyzed. Median PFS was 5.4 months in patients with G0-1 neutropenia, 6.9 months with G2-3 neutropenia (hazard ratio [HR] vs. G0-1, 0.69; 95% confidence interval [CI], 0.35-1.35; P = .27) and 9.5 months with G4 neutropenia (HR vs. G0-1, 0.30; 95% CI, 0.16-0.57; P < .0001). Median OS was 11.6 months in patients with G0-1 neutropenia, 25.5 months in patients with G2-3 neutropenia (HR vs. G0-1, 0.36; 95% CI, 0.16-0.80; P = .012) and 39.3 months in patients with G4 neutropenia (HR vs. G0-1, 0.19; 95% CI, 0.09-0.41; P < .0001). In multivariate analysis, the occurrence of severe neutropenia showed a statistically significant association with OS (HR G4 vs. G0-1, 0.14; 95% CI, 0.03-0.67; P = .013; HR G2-3 vs. G0-1, 0.42; 95% CI, 0.11-1.57; P = .20) and PFS (HR G4 vs. G0-1, 0.28; 95% CI, 0.09-0.86; P = .03; HR G2-3 vs. G0-1, 1.07; 95% CI, 0.38-2.96; P = .90).
CONCLUSION
Docetaxel-induced neutropenia is associated with better survival of mCRPC.
背景
中性粒细胞减少是与多西他赛使用相关的常见副作用。我们回顾性调查了转移性去势抵抗性前列腺癌（mCRPC）患者接受一线多西他赛治疗时，化疗引起的中性粒细胞减少与生存之间的关系。
患者和方法
本回顾性分析纳入了接受一线多西他赛治疗且首次给药后 10 天已知中性粒细胞值的转移性去势抵抗性前列腺癌患者。中性粒细胞减少分为 0 级至 1 级（G0-1）、2 级至 3 级（G2-3）和 4 级（G4）。主要终点是无进展生存期（PFS）和总生存期（OS）。
结果
分析了 80 例患者。中性粒细胞减少为 G0-1 的患者中位 PFS 为 5.4 个月，中性粒细胞减少为 G2-3 的患者中位 PFS 为 6.9 个月（G2-3 与 G0-1 相比，HR 为 0.69；95%CI，0.35-1.35；P=0.27），中性粒细胞减少为 G4 的患者中位 PFS 为 9.5 个月（G4 与 G0-1 相比，HR 为 0.30；95%CI，0.16-0.57；P<0.0001）。中性粒细胞减少为 G0-1 的患者中位 OS 为 11.6 个月，中性粒细胞减少为 G2-3 的患者中位 OS 为 25.5 个月（G2-3 与 G0-1 相比，HR 为 0.36；95%CI，0.16-0.80；P=0.012），中性粒细胞减少为 G4 的患者中位 OS 为 39.3 个月（G4 与 G0-1 相比，HR 为 0.19；95%CI，0.09-0.41；P<0.0001）。多变量分析显示，严重中性粒细胞减少与 OS（G4 与 G0-1 相比，HR 为 0.14；95%CI，0.03-0.67；P=0.013；G2-3 与 G0-1 相比，HR 为 0.42；95%CI，0.11-1.57；P=0.20）和 PFS（G4 与 G0-1 相比，HR 为 0.28；95%CI，0.09-0.86；P=0.03；G2-3 与 G0-1 相比，HR 为 1.07；95%CI，0.38-2.96；P=0.90）存在统计学显著相关性。
结论
多西他赛引起的中性粒细胞减少与 mCRPC 的生存改善有关。
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