Lehmann J, Kluike C W, Haider A, Haider K S, Baumann S, Flesch M, Gedamke M, Kägebein D
Urologische Gemeinschaftspraxis Prüner Gang, Gesundheitszentrum Kiel-Mitte, Prüner Gang 15., 24103, Kiel, Deutschland.
Urologie am Wasserturm, Lüneburg, Deutschland.
Urologe A. 2022 Feb;61(2):173-182. doi: 10.1007/s00120-021-01620-7. Epub 2021 Aug 17.
Androgen deprivation therapy (ADT) with a GnRH agonist or the GnRH antagonist degarelix is a central component in the treatment of prostate cancer (PCa). Little is currently known regarding the decision criteria. Knowledge of these could improve the success of treatment in the future.
To identify factors influencing the treatment decision in patients with hormone-sensitive prostate cancer receiving ADT and to determine the incidence of concomitant disease in both treatment groups.
The two-arm, prospective, non-interventional study "ProComD" was conducted from September 2014 to June 2019 at 80 study centers in Germany. After the therapy decision was made, patients with hormone-sensitive prostate cancer needing ADT were included in the study. Data were collected during routine visits.
Data from 413 patients were evaluated (degarelix N = 268; GnRH agonists N = 145). Key factors influencing the therapy decision for both treatment options included comorbidities (42% of all patients), compliance (64%), and age (81%). The source of information consulted most frequently regarding existing comorbidities was the patient's medical history conducted by the treating urologist themselves (65% in both groups). For patients with pre-existing cardiovascular diseases, the doctor's letter (45.8% degarelix vs. 38.9% GnRH agonists) or the medical history questionnaire (38.9% degarelix vs. 20% GnRH agonists) was additionally taken into account.
Comorbidities along with age and compliance are among the key factors influencing the treatment decisions made by urologists.
使用促性腺激素释放激素(GnRH)激动剂或GnRH拮抗剂地加瑞克进行雄激素剥夺治疗(ADT)是前列腺癌(PCa)治疗的核心组成部分。目前关于决策标准知之甚少。了解这些标准可能会提高未来治疗的成功率。
确定影响接受ADT的激素敏感性前列腺癌患者治疗决策的因素,并确定两个治疗组中合并症的发生率。
双臂、前瞻性、非干预性研究“ProComD”于2014年9月至2019年6月在德国的80个研究中心进行。在做出治疗决策后,需要ADT的激素敏感性前列腺癌患者被纳入研究。数据在常规就诊期间收集。
对413例患者的数据进行了评估(地加瑞克组N = 268;GnRH激动剂组N = 145)。影响两种治疗方案治疗决策的关键因素包括合并症(占所有患者的42%)、依从性(64%)和年龄(81%)。关于现有合并症,最常查阅的信息来源是主治泌尿科医生自己进行的患者病史(两组均为65%)。对于已有心血管疾病的患者,还会考虑医生的信件(地加瑞克组为45.8%,GnRH激动剂组为38.9%)或病史问卷(地加瑞克组为38.9%,GnRH激动剂组为20%)。
合并症以及年龄和依从性是影响泌尿科医生治疗决策的关键因素。