Lin Yen-Chi, Lin Po-Hung, Shao I-Hung, Chu Yuan-Cheng, Kan Hung-Cheng, Liu Chung-Yi, Yu Kai-Jie, Chang Ying-Hsu, Pang See-Tong, Huang Jhen-Ling, Chuang Cheng-Keng
Division of Urology, Department of Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
Division of Urology, Department of Surgery, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital and Chang Gung University, New Taipei City, Taiwan.
J Oncol. 2021 Aug 26;2021:9648579. doi: 10.1155/2021/9648579. eCollection 2021.
The present study aimed to analyse factors influencing the effects of androgen deprivation therapy (ADT) in patients with newly diagnosed metastatic castration-naïve prostate cancer (mCNPC), especially in low-volume disease (LVD), according to subclassification of metastatic prostate cancer established by the CHAARTED trial.
We reviewed 648 patients with newly diagnosed mCNPC receiving ADT at Chang Gung Memorial Hospital from January 2007 to December 2016. Basic characteristics and PSA kinetics profile were subsequently evaluated.
48.3% of LVD patients progressed to castration-resistant prostate cancer (mCRPC). Among them, CRPC group had significantly shorter time to PSA nadir (TTN) and faster time from PSA nadir to CRPC (TFNTC) ( < 0.001) compared to non-CRPC group. PSA doubling time (PSADT) < 4 months tended to be associated with faster disease progression and shorter overall survival (OS). Among all patients with metastatic prostate cancer, those with shorter TTN <9 months, higher nadir PSA level ≥1 ng/mL, and shorter PSADT <3 months had increased tendency for biochemical progression.
PSADT is an effective clinical predictor for disease progression and survival in LVD. Other PSA kinetics including TTN and TFNTC, though not the major predictors for disease progression or OS in LVD, might be the predictors for disease control status.
本研究旨在根据CHAARTED试验建立的转移性前列腺癌亚分类，分析影响新诊断的转移性去势敏感性前列腺癌（mCNPC）患者，尤其是低瘤负荷疾病（LVD）患者雄激素剥夺治疗（ADT）效果的因素。
我们回顾了2007年1月至2016年12月在长庚纪念医院接受ADT的648例新诊断的mCNPC患者。随后评估了基本特征和PSA动力学曲线。
48.3%的LVD患者进展为去势抵抗性前列腺癌（mCRPC）。其中，与非CRPC组相比，CRPC组达到PSA最低点的时间（TTN）显著更短，从PSA最低点到CRPC的时间（TFNTC）更快（<0.001）。PSA倍增时间（PSADT）<4个月往往与疾病进展更快和总生存期（OS）更短相关。在所有转移性前列腺癌患者中，TTN<9个月、最低点PSA水平≥1 ng/mL且PSADT<3个月的患者生化进展倾向增加。
PSADT是LVD疾病进展和生存的有效临床预测指标。其他PSA动力学指标，包括TTN和TFNTC，虽然不是LVD疾病进展或OS的主要预测指标，但可能是疾病控制状态的预测指标。
