Matsumura Naoki, Fujita Kazutoshi, Nishimoto Mitsuhisa, Yamamoto Yutaka, Kuwahara Ken, Nagai Yasuharu, Minami Takafumi, Hatanaka Yuji, Nozawa Masahiro, Morimoto Yasuhiro, Tahara Hideo, Uejima Shigeya, Esa Atsunobu, Hirayama Akihide, Yoshimura Kazuhiro, Uemura Hirotsugu
Department of Urology, Mimihara General Hospital, Sakai Sakai-ku, Japan.
Department of Urology, Faculty of Medicine, Kindai University Hospital, Osakasayama, Japan.
Front Oncol. 2021 Dec 21;11:769068. doi: 10.3389/fonc.2021.769068. eCollection 2021.
This study aimed to compare the effects of abiraterone acetate plus prednisone (AAP) with androgen deprivation therapy (ADT) with those of combined androgen blockade (CAB) therapy in patients with high-risk metastatic hormone-sensitive prostate cancer (mHSPC). This study retrospectively identified 163 patients with high-risk mHSPC at Kindai University and affiliated hospitals between January 2014 and December 2020. Kaplan-Meier analysis was used to summarize progression-free survival (PFS) and overall survival (OS). Multivariate Cox proportional hazard modeling was used to identify the prognostic factors in the overall cohort. Propensity score matching was used to adjust the clinical characteristics, and log-rank test was applied to these propensity score-matched cohorts. Seventy-four patients who received AAP with ADT and 89 patients who received CAB were included in this study. The median follow-up duration was 27 months (range, 2-89 months). The median PFS and OS were not reached by the AAP+ADT group and 15 and 79 months, respectively, in the CAB group. The Eastern Cooperative Oncology Group (ECOG) performance status (PS) score and AAP+ADT were significant prognostic factors for PFS, whereas ECOG PS score, visceral metastasis, and AAP+ADT were significant prognostic factors for OS. The 2-year PFS was 76.1% in the AAP+ADT group and 38.6% in the CAB group (P < 0.0001), and the 2-year OS was 90.2% in the AAP+ADT group and 84.8% in the CAB group (P = 0.015). In conclusion, AAP+ADT had better PFS and OS than CAB in patients with high-risk mHSPC.
本研究旨在比较醋酸阿比特龙联合泼尼松（AAP）与雄激素剥夺疗法（ADT）以及联合雄激素阻断（CAB）疗法对高危转移性激素敏感性前列腺癌（mHSPC）患者的疗效。本研究回顾性纳入了2014年1月至2020年12月期间在近畿大学及其附属医院的163例高危mHSPC患者。采用Kaplan-Meier分析总结无进展生存期（PFS）和总生存期（OS）。使用多变量Cox比例风险模型确定整个队列中的预后因素。采用倾向评分匹配来调整临床特征，并对这些倾向评分匹配的队列应用对数秩检验。本研究纳入了74例接受AAP联合ADT的患者和89例接受CAB的患者。中位随访时间为27个月（范围2 - 89个月）。AAP + ADT组未达到中位PFS，CAB组的中位PFS和OS分别为15个月和79个月。东部肿瘤协作组（ECOG）体能状态（PS）评分和AAP + ADT是PFS的显著预后因素，而ECOG PS评分、内脏转移和AAP + ADT是OS的显著预后因素。AAP + ADT组的2年PFS为76.1%，CAB组为38.6%（P < 0.0001），AAP + ADT组的2年OS为90.2%，CAB组为84.8%（P = 0.015）。总之，在高危mHSPC患者中，AAP + ADT的PFS和OS优于CAB。
