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多西他赛副作用与后续卡巴他赛用于去势抵抗性前列腺癌的相关性:一项临床研究

[The Association of Docetaxel Side Effects and Introduction of Subsequent Cabazitaxel for Castration-Resistant Prostate Cancer : A Clinical Study].

作者信息

Kujime Yuma, Sato Mototaka, Maekawa Takahiro, Umeda Shun, Matsushita Makoto, Tei Norihide, Miyake Osamu

机构信息

The Department of Urology, Toyonaka Municipal Hospital.

出版信息

Hinyokika Kiyo. 2024 Jun;70(6):141-147. doi: 10.14989/ActaUrolJap_70_6_141.

Abstract

The administration of cabazitaxel for patients with castration-resistant prostate cancer (CRPC) requires prior docetaxel therapy. Sequential chemotherapy may have to be discontinued due to docetaxelassociated side effects. This study investigated the relationship between treatment outcome of docetaxel and cabazitaxel and their associated side effects. We retrospectively analyzed 69 patients with CRPC who had been administered docetaxel withand without subsequent cabazitaxel at Toyonaka Municipal Hospital from October 2014 to June 2022. Twenty-eight patients (41%) discontinued docetaxel because of side effects, and the median number of docetaxel cycles at discontinuation was 2 (range : 1-11). Fourteen of these patients received no treatment following docetaxel. A comparison of the 28 patients who had discontinued docetaxel due to side effects with 41 patients who had not revealed a significant difference in the total numbers of chemotherapy cycles (2.5 vs 9 ; P<0.001) and time to treatment failure (56 days vs 301 days ; P= 0.001), with a trend toward shorter overall survival from the start of docetaxel treatment (259 days vs 512 days ; P=0.06). Multivariate analysis identified discontinuation of docetaxel due to side effects (OR=0.07 ; P<0.001) and lower hemoglobin (OR=0.01 ; P=0.001) as significant factors inhibiting the introduction of cabazitaxel. Reducing the side effects of docetaxel, including early drug switching, may allow more CRPC patients to be reached with cabazitaxel. Consequently, the resulting taxane-based chemotherapy may contribute to an additional survival advantage.

摘要

对于去势抵抗性前列腺癌(CRPC)患者,卡巴他赛给药需要先前接受多西他赛治疗。由于多西他赛相关的副作用,序贯化疗可能不得不中断。本研究调查了多西他赛和卡巴他赛的治疗结果与其相关副作用之间的关系。我们回顾性分析了2014年10月至2022年6月在丰中市立医院接受多西他赛治疗且随后接受或未接受卡巴他赛治疗的69例CRPC患者。28例患者(41%)因副作用中断多西他赛治疗,中断时多西他赛的中位疗程数为2个(范围:1 - 11个)。这些患者中有14例在多西他赛治疗后未接受任何治疗。将28例因副作用中断多西他赛治疗的患者与41例未中断治疗的患者进行比较,结果显示化疗总疗程数(2.5个 vs 9个;P<0.001)和至治疗失败时间(56天 vs 301天;P=0.001)存在显著差异,从多西他赛治疗开始的总生存期有缩短趋势(259天 vs 512天;P=0.06)。多因素分析确定因副作用中断多西他赛治疗(OR=0.07;P<0.001)和血红蛋白水平较低(OR=0.01;P=0.001)是阻碍引入卡巴他赛的显著因素。减少多西他赛的副作用,包括早期换药,可能使更多CRPC患者能够接受卡巴他赛治疗。因此,由此产生的基于紫杉烷的化疗可能有助于获得额外的生存优势。

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