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新辅助促黄体生成素释放激素拮抗剂联合替加氟-尿嘧啶化学激素疗法治疗高危前列腺癌的疗效与安全性

Efficacy and Safety of Neoadjuvant Luteinizing Hormone-Releasing Hormone Antagonist and Tegafur-Uracil Chemohormonal Therapy for High-Risk Prostate Cancer.

作者信息

Sugino Fumiya, Nakane Keita, Kawase Makoto, Ueda Shota, Tomioka Masayuki, Takeuchi Yasumichi, Tomioka-Inagawa Risa, Yamada Toyohiro, Namiki Sanae, Kumada Naotaka, Takeuchi Shinichi, Kawase Kota, Kato Daiki, Takai Manabu, Iinuma Koji, Tobisawa Yuki, Koie Takuya

机构信息

Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan.

Department of Urology, Japanese Red Cross Takayama Hospital, Takayama 5068550, Japan.

出版信息

Life (Basel). 2023 Apr 23;13(5):1072. doi: 10.3390/life13051072.

Abstract

BACKGROUND

This retrospective single-center cohort study evaluated the efficacy and safety of a combination of neoadjuvant luteinizing hormone-releasing hormone (LHRH) antagonist and tegafur-uracil (UFT) therapy (NCHT) and investigated the medical records of patients with high-risk PCa who underwent robot-assisted radical prostatectomy (RARP). The therapy was followed by RARP for high-risk PCa.

MATERIALS AND METHODS

The enrolled patients were divided into two groups: low-intermediate-risk PCa patients who underwent RARP without neoadjuvant therapy (non-high-risk) and those who underwent NCHT followed by RARP (high-risk group). This study enrolled 227 patients (126: non-high-risk and 101: high-risk group). Patients in the high-risk-group had high-grade cancer compared to those in the non-high-risk-group.

RESULTS

At the median follow-up period of 12.0 months, there were no PCa deaths; two patients (0.9%) died of other causes. Twenty patients developed biochemical recurrence (BCR); the median time until BCR was 9.9 months after surgery. The 2-year biochemical recurrence-free survival rates were 94.2% and 91.1% in the non-high-risk and high-risk-group, respectively ( = 0.465). Grade ≥3 NCHT-related adverse events developed in nine patients (8.9%).

CONCLUSIONS

This study indicates that combining neoadjuvant LHRH antagonists and UFT followed by RARP may improve oncological outcomes in patients with high-risk PCa.

摘要

背景

这项回顾性单中心队列研究评估了新辅助促黄体生成素释放激素(LHRH)拮抗剂与替加氟-尿嘧啶(UFT)联合治疗(NCHT)的疗效和安全性,并调查了接受机器人辅助根治性前列腺切除术(RARP)的高危前列腺癌患者的病历。该治疗后对高危前列腺癌患者进行RARP。

材料与方法

纳入的患者分为两组:未接受新辅助治疗而行RARP的低中危前列腺癌患者(非高危组)和接受NCHT后行RARP的患者(高危组)。本研究纳入了227例患者(126例:非高危组和101例:高危组)。与非高危组患者相比,高危组患者患有高级别癌症。

结果

在中位随访期12.0个月时,无前列腺癌死亡病例;2例患者(0.9%)死于其他原因。20例患者发生生化复发(BCR);至BCR的中位时间为术后9.9个月。非高危组和高危组的2年无生化复发生存率分别为94.2%和91.1%(P = 0.465)。9例患者(8.9%)发生了≥3级NCHT相关不良事件。

结论

本研究表明,新辅助LHRH拮抗剂与UFT联合应用后行RARP可能改善高危前列腺癌患者的肿瘤学结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca66/10223720/204449d2369a/life-13-01072-g001.jpg

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