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在接受多西他赛治疗的转移性去势抵抗性前列腺癌患者中,初始雄激素剥夺治疗期间的前列腺特异性抗原(PSA)最低点及达到PSA最低点的时间作为预后因素。

PSA nadir and time to PSA nadir during initial androgen deprivation therapy as prognostic factors in metastatic castration-resistance prostate cancer patients treated with docetaxel.

作者信息

Shi Xinyu, Pei Xinqi, Fan Junjie, Liu Tianjie, Zhang Dize, Yang Tao, Wu Kaijie, He Dalin, Li Lei

机构信息

Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

Department of Urology, Baoji Center Hospital, Baoji, China.

出版信息

Andrologia. 2021 May;53(4):e13916. doi: 10.1111/and.13916. Epub 2021 Feb 16.

Abstract

Prostate-specific antigen nadir (nPSA) and time to nPSA (TTN) have been proved to be associated with the prognosis of prostate cancer. In this study, we explored the prognosis effect of nPSA and TTN during initial androgen deprivation therapy (ADT) in patients with metastatic castration-resistant prostate cancer (mCRPC) after treatment with docetaxel-based chemotherapy. The data of 153 mCRPC patients received docetaxel followed by ADT were retrospectively reviewed. Multivariate Cox regression analysis demonstrated that TTN (overall survival (OS): Hazard ratio [HR] 0.096, 95% confidence interval [CI] 0.045-0.206, p < .001; progression-free survival (PFS): HR 0.128, 95% CI 0.078-0.211, p < .001) and nPSA (OS: HR 2.849, 95% CI 1.318-6.157, p = .008; PFS: HR 1.573, 95% CI 1.008-2.454, p = .046) acted as independent predictors of chemotherapy prognosis. Kaplan-Meier analysis showed that patients with nPSA ≥ 0.2 ng/ml or TTN < 6.5 months had shorter OS and PFS. These results suggest that TTN and nPSA during ADT can affect the prognosis of docetaxel-based chemotherapy prognosis post-castration resistance in patients with mCRPC, and higher nPSA and shorter TTN lead to poor chemotherapy prognosis. What is more, TTN has a greater impact during ADT on the prognosis of chemotherapy than nPSA.

摘要

前列腺特异性抗原最低点(nPSA)和达到nPSA的时间(TTN)已被证明与前列腺癌的预后相关。在本研究中,我们探讨了在接受多西他赛化疗后的转移性去势抵抗性前列腺癌(mCRPC)患者初始雄激素剥夺治疗(ADT)期间nPSA和TTN对预后的影响。回顾性分析了153例接受多西他赛治疗后再接受ADT的mCRPC患者的数据。多变量Cox回归分析表明,TTN(总生存期(OS):风险比[HR] 0.096,95%置信区间[CI] 0.045 - 0.206,p <.001;无进展生存期(PFS):HR 0.128,95% CI 0.078 - 0.211,p <.001)和nPSA(OS:HR 2.849,95% CI 1.318 - 6.157,p = 0.008;PFS:HR 1.573,95% CI 1.008 - 2.454,p = 0.046)是化疗预后的独立预测因素。Kaplan-Meier分析显示,nPSA≥0.2 ng/ml或TTN < 6.5个月的患者OS和PFS较短。这些结果表明ADT期间的TTN和nPSA可影响mCRPC患者去势抵抗后基于多西他赛化疗的预后,nPSA越高和TTN越短导致化疗预后越差。此外,ADT期间TTN对化疗预后的影响比nPSA更大。

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