前列腺特异性抗原倍增时间可预测针对寡进展性去势抵抗性前列腺癌的局部治疗疗效。
Prostate-specific antigen doubling time predicts the efficacy of site-directed therapy for oligoprogressive castration-resistant prostate cancer.
作者信息
Kawai Taketo, Taguchi Satoru, Nozaki Keina, Kimura Naoki, Oshina Takahiro, Iwaki Takuya, Matsui Hotaka, Niimi Aya, Kamei Jun, Akiyama Yoshiyuki, Yamada Yuta, Sato Yusuke, Yamada Daisuke, Kaneko Tomoyuki, Sawayanagi Subaru, Nakayama Hidetsugu, Minamimoto Ryogo, Yamashita Hideomi, Miyazaki Hideyo, Fujimura Tetsuya, Nakagawa Tohru, Kume Haruki
机构信息
Department of Urology, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan.
Department of Urology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
出版信息
Prostate Int. 2023 Dec;11(4):239-246. doi: 10.1016/j.prnil.2023.10.002. Epub 2023 Oct 21.
BACKGROUND
In recent years, site-directed therapies (SDTs) targeting progressive lesions in patients with oligometastatic prostate cancer have attracted attention. However, whether they effectively treat oligoprogressive castration-resistant prostate cancer (CRPC) remains unclear. Here, we investigated the efficacy of SDT in patients with oligoprogressive CRPC and identified prognostic factors.
METHODS
We reviewed 59 patients with oligoprogressive CRPC who underwent SDT targeting prostate or metastatic lesions between April 2014 and March 2022. We evaluated the associations between several pretreatment clinical variables and treatment procedures and a >50% prostate-specific antigen (PSA) response, progression-free survival (PFS), and time to next treatment (TTNT).
RESULTS
A PSA response of >50% was observed in 66% of patients. The median PFS and TTNT were 8.3 months and 9.9 months, respectively. Patients with PSA doubling time ≥6 months showed a higher >50% PSA response rate (87% vs. 45%; < 0.001), longer PFS (median, 15.0 vs. 5.0 months; < 0.001), and longer TTNT (median, 16.3 vs. 5.9 months; < 0.001) than patients with PSA doubling time <6 months. In multivariate analyses, a PSA doubling time of ≥6 months independently predicted a >50% PSA response, favorable PFS, and TTNT ( = 0.037, 0.025, and 0.017, respectively).
CONCLUSION
PSA doubling time of ≥6 months may be a key indicator of the favorable efficacy of SDT for oligoprogressive CRPC.
背景
近年来，针对寡转移前列腺癌患者进展性病灶的靶向治疗（SDTs）受到关注。然而，它们是否能有效治疗寡进展性去势抵抗性前列腺癌（CRPC）仍不清楚。在此，我们研究了SDT对寡进展性CRPC患者的疗效，并确定了预后因素。
方法
我们回顾了2014年4月至2022年3月期间接受针对前列腺或转移病灶的SDT治疗的59例寡进展性CRPC患者。我们评估了几个治疗前临床变量和治疗程序与前列腺特异性抗原（PSA）应答率>50%、无进展生存期（PFS）和下次治疗时间（TTNT）之间的关联。
结果
66%的患者观察到PSA应答率>50%。中位PFS和TTNT分别为8.3个月和9.9个月。PSA倍增时间≥6个月的患者显示出更高的PSA应答率>50%（87%对45%；<0.001）、更长的PFS（中位值，15.0对5.0个月；<0.001）以及更长的TTNT（中位值，16.3对5.9个月；<0.001），相比于PSA倍增时间<6个月的患者。在多变量分析中，PSA倍增时间≥6个月独立预测了PSA应答率>50%、良好的PFS和TTNT（分别为=0.037、0.025和0.017）。
结论
PSA倍增时间≥6个月可能是SDT对寡进展性CRPC疗效良好的关键指标。
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