一项全港性、多中心、按年龄和前列腺特异性抗原匹配的研究，比较了中国转移性激素敏感前列腺癌男性患者接受单纯化疗与单纯内分泌治疗的效果。

A Territory-wide, Multicenter, Age- and Prostate-specific Antigen-matched Study Comparing Chemohormonal Therapy and Hormonal Therapy Alone in Chinese Men With Metastatic Hormone-sensitive Prostate Cancer.

机构信息

S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.

Department of Clinical Oncology, State Key Laboratory in Oncology in South China, Sir YK Pao Centre for Cancer, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.

出版信息

Clin Genitourin Cancer. 2019 Feb;17(1):e203-e208. doi: 10.1016/j.clgc.2018.10.010. Epub 2018 Oct 27.

DOI:10.1016/j.clgc.2018.10.010

PMID:30454968

Abstract

BACKGROUND

There is a lack of real-world data regarding the treatment outcomes of chemohormonal therapy versus hormonal therapy alone in Chinese men with metastatic hormone-sensitive prostate cancer.

PATIENTS AND METHODS

We conducted a territory-wide, multicenter, age- and prostate-specific antigen (PSA)-matched cohort study comparing chemohormonal therapy and hormonal therapy alone in Chinese men with metastatic hormone-sensitive prostate cancer. Patient and disease characteristics were reviewed. The primary outcome was PSA progression-free survival. Secondary outcomes included clinical progression-free survival and castration resistance-free survival. Kaplan-Meier and multivariate Cox regression analyses were performed.

RESULTS

From January 2015 to July 2016, 32 Chinese men with metastatic hormone-sensitive prostate cancer were treated with chemohormonal therapy, and they were matched to 32 Chinese men who were treated with hormonal therapy alone. Patient and disease characteristics were similar between the 2 groups. The chemohormonal therapy group had a significantly better PSA progression-free survival (P = .001) and castration resistance-free survival (P = .002) than the hormonal therapy group. There was no significant difference in the clinical progression-free survival between the 2 groups. Upon multivariate Cox regression analyses, the use of chemohormonal therapy was significantly associated with a longer time to PSA progression (hazard ratio, 0.31; 95% confidence interval, 0.31-0.73; P = .008) and a longer time to castration resistance (hazard ratio, 0.38; 95% confidence interval, 0.17-0.83; P = .015), but was not associated with clinical progression.

CONCLUSIONS

The use of chemohormonal therapy could prevent PSA progression and the development of castration resistance when compared with hormonal therapy alone in Chinese men with metastatic hormone-sensitive prostatic cancer.

摘要

背景

缺乏关于转移性激素敏感前列腺癌中国男性接受化疗联合激素治疗与单纯激素治疗的结局的真实世界数据。

患者和方法

我们进行了一项全港范围内、多中心、按年龄和前列腺特异性抗原（PSA）匹配的队列研究，比较了转移性激素敏感前列腺癌中国男性中化疗联合激素治疗与单纯激素治疗。回顾了患者和疾病特征。主要结局是 PSA 无进展生存。次要结局包括临床无进展生存和去势抵抗无进展生存。进行了 Kaplan-Meier 分析和多变量 Cox 回归分析。

结果

2015 年 1 月至 2016 年 7 月，32 例转移性激素敏感前列腺癌患者接受了化疗联合激素治疗，与 32 例接受单纯激素治疗的患者相匹配。两组患者和疾病特征相似。化疗联合激素治疗组 PSA 无进展生存（P=0.001）和去势抵抗无进展生存（P=0.002）明显优于单纯激素治疗组。两组间临床无进展生存无显著差异。多变量 Cox 回归分析显示，化疗联合激素治疗与 PSA 进展时间延长显著相关（风险比，0.31；95%置信区间，0.31-0.73；P=0.008）和去势抵抗时间延长显著相关（风险比，0.38；95%置信区间，0.17-0.83；P=0.015），但与临床进展无关。