Suer Evren, Hamidi Nurullah, Akpinar Cagri, Gokce Mehmet Ilker, Gulpinar Omer, Turkolmez Kadir, Beduk Yasar, Baltaci Sumer
Ankara University School of Medicine, Department of Urology, Ankara, TURKEY.
Ankara Atatürk Research and Training Hospital, Department of Urology, Ankara, TURKEY.
Urol J. 2019 Oct 21;16(5):453-457. doi: 10.22037/uj.v0i0.4497.
To investigate the prognostic role of time to castration resistance(TTCR) in patients who have received solely Docetaxel chemotherapy regimen(DCR) for castration resistant prostate cancer(CRPC).
Between Jan 2004 and Dec 2015, data of 162 patients who have received DCR for CRPC were gath-ered. Patients were divided into three groups according to TTCR: Group 1(? 12 months), group 2(13-24 months), and group 3(>24 months). Data of age, clinical stage, Gleason grade(GG), previous treatments, site of metastases, Prostate-specific antigen (PSA) values, TTCR, overall survival, biochemical progression free survival(PFS) and PSA response to docetaxel were recorded.
The mean age of the 162 patients was 74.4 ± 8.5 years. Data on mean age, type of castration, adding estra-mustine to docetaxel, secondary hormonal manipulation, Gleason grade, clinical T stage at initial diagnosis and site of metastases were comparable between three groups. PSA values were higher in group 1 than other groups. PSA response to docetaxel was 59.2% in all patient and it was worse in group 1 than other groups (P = .009). Two years overall survival rates were 7.6%, 25% and 32.3% in group 1, 2 and 3, respectively. Median survival rates were 7, 14 and 23 months in group 1, 2 and 3, respectively, and this difference was statistically significant (P=.016). On multivariate analysis, TTCR was found to be independent prognostic factor for overall survival and response to docetaxel treatment.
TTCR appears to be an independent prognostic factor for patients who are candidates for DCR.
探讨去势抵抗时间(TTCR)在仅接受多西他赛化疗方案(DCR)治疗的去势抵抗性前列腺癌(CRPC)患者中的预后作用。
收集2004年1月至2015年12月期间162例接受DCR治疗的CRPC患者的数据。根据TTCR将患者分为三组:第1组(≤12个月)、第2组(13 - 24个月)和第3组(>24个月)。记录患者的年龄、临床分期、 Gleason分级(GG)、既往治疗情况、转移部位、前列腺特异性抗原(PSA)值、TTCR、总生存期、生化无进展生存期(PFS)以及PSA对多西他赛的反应。
162例患者的平均年龄为74.4±8.5岁。三组患者的平均年龄、去势类型、多西他赛联合雌莫司汀、二线激素治疗、Gleason分级、初始诊断时的临床T分期及转移部位的数据具有可比性。第1组的PSA值高于其他组。所有患者中PSA对多西他赛的反应率为59.2%,第1组的反应率低于其他组(P = 0.009)。第1组、第2组和第3组的两年总生存率分别为7.6%、25%和32.3%。第1组、第2组和第3组的中位生存期分别为7个月、14个月和23个月,差异具有统计学意义(P = 0.016)。多因素分析显示,TTCR是总生存期和多西他赛治疗反应的独立预后因素。
TTCR似乎是DCR候选患者的独立预后因素。