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在韩国真实世界实践中,多西他赛联合雄激素剥夺疗法治疗转移性激素敏感前列腺癌的疗效。

Effectiveness of Adding Docetaxel to Androgen Deprivation Therapy for Metastatic Hormone-Sensitive Prostate Cancer in Korean Real-World Practice.

机构信息

Medical Oncology and Hematology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.

Division of Hemato-Oncology, Keimyung University Dongsan Hospital, Daegu, Korea.

出版信息

Yonsei Med J. 2023 Feb;64(2):86-93. doi: 10.3349/ymj.2022.0244.

Abstract

PURPOSE

Evidence in favor of adding docetaxel in treatment of metastatic hormone-sensitive prostate cancer (mHSPC) has led to docetaxel in conjunction with androgen deprivation therapy (ADT) as standard therapy. The aim of this study was to examine the effectiveness of docetaxel with ADT for Korean patients with mHSPC in real-world practice.

MATERIALS AND METHODS

A retrospective cohort study was performed at six Korean hospitals for patients with mHSPC treated with docetaxel plus ADT. Patients were treated every 3 weeks for up to six cycles with 75 mg/m² of docetaxel. The primary endpoint was time to castration resistant prostate cancer (CRPC).

RESULTS

This study included 46 eligible patients from June 2016 to February 2021. Median age was 68.5 years (range, 52-84) and all patients present with de novo M1 with high-volume disease. The median prostate-specific antigen (PSA) level at ADT initiation was 205.4 (7.7-1933) ng/mL, and time from ADT to docetaxel was 2.4 months (0-5.3). All six planned cycles of docetaxel were delivered in 36 patients (78%), 7 patients (15%) discontinued treatment due to adverse events, and 3 patients (7%) discontinued due to progression. At the time of the analysis, CRPC had developed in 34 patients (74%), and the median time to CRPC was 18.0 (95% confidence interval, 14.1-21.9) months. PSA <0.2 ng/mL was achieved in 11 patients (24%) after 6 months of ADT and in 10 patients (22%) after 12 months. At last follow-up, 35 patients (76%) were alive; the median overall survival was not reached.

CONCLUSION

The effect of docetaxel combined with ADT for Korean patients with mHSPC is comparable with prior results in Western studies.

摘要

目的

支持在转移性激素敏感前列腺癌(mHSPC)治疗中添加多西他赛的证据导致多西他赛联合雄激素剥夺疗法(ADT)成为标准治疗。本研究的目的是在真实世界实践中检查多西他赛联合 ADT 治疗韩国 mHSPC 患者的有效性。

材料和方法

对六家韩国医院的 mHSPC 患者进行了回顾性队列研究,这些患者接受多西他赛联合 ADT 治疗。患者每 3 周接受一次治疗,最多接受 6 个周期,每个周期给予 75mg/m²多西他赛。主要终点是去势抵抗性前列腺癌(CRPC)的时间。

结果

本研究纳入了 2016 年 6 月至 2021 年 2 月期间的 46 名符合条件的患者。中位年龄为 68.5 岁(范围为 52-84 岁),所有患者均为新发 M1 且伴有大量疾病。ADT 起始时前列腺特异性抗原(PSA)水平的中位数为 205.4(7.7-1933)ng/mL,ADT 至多西他赛的时间为 2.4 个月(0-5.3)。36 名患者(78%)接受了全部 6 个计划周期的多西他赛治疗,7 名患者(15%)因不良事件停止治疗,3 名患者(7%)因进展停止治疗。在分析时,34 名患者(74%)已发展为 CRPC,CRPC 的中位时间为 18.0(95%置信区间,14.1-21.9)个月。ADT 后 6 个月,11 名患者(24%)PSA<0.2ng/mL,12 个月后 10 名患者(22%)PSA<0.2ng/mL。末次随访时,35 名患者(76%)存活;中位总生存期未达到。

结论

多西他赛联合 ADT 治疗韩国 mHSPC 患者的效果与西方研究的先前结果相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c67/9892544/aa738cb85ead/ymj-64-86-g001.jpg

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