Miyazawa Yoshiyuki, Nakamura Toshiyuki, Takezawa Yutaka, Shimizu Nobuaki, Matsuo Yasushige, Ogura Haruyuki, Takei Tomoyuki, Sekine Yoshitaka, Arai Seiji, Suzuki Kazuhiro
Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Japan.
Department of Urology, Tatebayashi Kosei Hospital, Tatebayashi, Japan.
Prostate. 2023 Jun;83(8):759-764. doi: 10.1002/pros.24514. Epub 2023 Mar 9.
Enzalutamide (ENZ) is used in the treatment of patients with castration-resistant prostate cancer (CRPC). The quality of life (QoL) of CRPC patients during ENZ treatment is very important, but predictive markers of QoL have not been identified. We investigated the relationship between the serum testosterone (T) level before ENZ treatment and QoL changes in CRPC patients.
This prospective study was conducted between 2014 and 2018 at Gunma University Hospital and related facilities. We analyzed 95 patients in whom QoL could be evaluated using the Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire at baseline, and after 4 and 12 weeks of ENZ treatment. Serum T levels were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS).
The study population of 95 patients had a median age of 72 years and median prostate-specific antigen level of 21.6 ng/mL. The median overall survival from the commencement of ENZ treatment was 26.8 months. The median serum T level before ENZ treatment was 50.0 pg/mL. The mean total FACT-P scores at baseline, and after 4 and 12 weeks of ENZ treatment, were 95.8, 91.7, and 90.1, respectively. Differences in FACT-P scores between the high T level (High-T) group and low T level (Low-T) group (distinguished based on median split of the T level) were examined. The mean FACT-P scores were significantly higher in the High-T than Low-T group after both 4 and 12 weeks of ENZ treatment (98.5 vs. 84.6 and 96.4 vs. 82.2, respectively, both p < 0.05). The mean FACT-P score was significantly lower in the Low-T group after 12 weeks than before ENZ treatment (p < 0.05).
The serum T level before treatment may be useful for predicting QoL changes after ENZ treatment in CRPC patients.
恩杂鲁胺（ENZ）用于治疗去势抵抗性前列腺癌（CRPC）患者。CRPC患者在接受ENZ治疗期间的生活质量（QoL）非常重要，但尚未确定QoL的预测标志物。我们研究了ENZ治疗前血清睾酮（T）水平与CRPC患者QoL变化之间的关系。
这项前瞻性研究于2014年至2018年在群马大学医院及相关机构进行。我们分析了95例患者，这些患者在基线时以及ENZ治疗4周和12周后，可使用癌症治疗功能评估-前列腺（FACT-P）问卷对QoL进行评估。血清T水平通过液相色谱-串联质谱法（LC-MS/MS）测定。
95例患者的研究人群中位年龄为72岁，前列腺特异性抗原水平中位数为21.6 ng/mL。从ENZ治疗开始的中位总生存期为26.8个月。ENZ治疗前血清T水平中位数为50.0 pg/mL。在基线时以及ENZ治疗4周和12周后，FACT-P总评分均值分别为95.8、91.7和90.1。检查了高T水平（High-T）组和低T水平（Low-T）组（根据T水平的中位数划分）之间FACT-P评分的差异。在ENZ治疗4周和12周后，High-T组的FACT-P评分均值均显著高于Low-T组（分别为98.5对84.6和96.4对82.2，均p < 0.05）。Low-T组在12周后的FACT-P评分均值显著低于ENZ治疗前（p < 0.05）。
治疗前血清T水平可能有助于预测CRPC患者接受ENZ治疗后的QoL变化。
