雄激素剥夺治疗后 3 个月前列腺特异性抗原水平可预测转移性去势敏感性前列腺癌患者的生存情况。
Three-month Prostate-specific Antigen Level After Androgen Deprivation Therapy Predicts Survival in Patients With Metastatic Castration-sensitive Prostate Cancer.
机构信息
Department of Urology School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan;
Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
出版信息
In Vivo. 2021 Mar-Apr;35(2):1101-1108. doi: 10.21873/invivo.12355.
BACKGROUND/AIM: Although upfront combination therapies with androgen deprivation are recommended for patients with castration-sensitive prostate cancer (CSPC), combination therapies may be excessive for some patients. The aim of this study was to identify patients with favorable outcome under androgen deprivation therapy (ADT) alone.
PATIENTS AND METHODS
This study consisted of 242 patients with CSPC who received ADT alone. The association between 3-month prostate-specific antigen (PSA) value after ADT and survival was analyzed.
RESULTS
The median overall survival for men with high-volume and/or high-risk cancer and those with low-volume low-risk cancer were 48.0 months and 103.0 months, respectively (p≤0.0001). Notably, in patients with low-volume low-risk cancer, the median overall survival for patients who achieved PSA ≤2 ng/ml at 3 months after ADT initiation was quite long at 112.0 months.
CONCLUSION
Conventional ADT may be sufficient and upfront combination therapy may be excessive for those patients with favorable outcome.
背景/目的：尽管推荐对去势敏感型前列腺癌（CSPC）患者进行雄激素剥夺的 upfront 联合治疗，但联合治疗对某些患者可能是过度的。本研究的目的是确定仅接受雄激素剥夺治疗（ADT）即可获得良好预后的患者。
患者和方法
本研究纳入了 242 例仅接受 ADT 的 CSPC 患者。分析了 ADT 后 3 个月前列腺特异性抗原（PSA）值与生存之间的关系。
结果
高体积和/或高危癌症患者和低体积低危癌症患者的中位总生存期分别为 48.0 个月和 103.0 个月（p≤0.0001）。值得注意的是，在低体积低危癌症患者中，ADT 开始后 3 个月 PSA≤2ng/ml 的患者中位总生存期相当长，为 112.0 个月。
结论
对于那些有良好预后的患者，常规 ADT 可能已经足够， upfront 联合治疗可能是过度的。
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