Clinical observation of second-line chemotherapy of pemetrexed combined with oxaliplatin in the treatment of metastatic castration-resistant prostate cancer
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摘要: 目的:观察培美曲塞联合奥沙利铂二线化疗治疗多西他赛联合泼尼松治疗后发展为转移性去势抵抗性前列腺癌(mCRPC)的临床效果及安全性。方法:选取2012年1月~2015年1月在我院因多西他赛联合泼尼松治疗后发展为mCRPC患者82例为研究对象,患者均采用培美曲塞联合奥沙利铂二线化疗方案进行治疗,观察治疗后的临床效果及用药安全性。结果:82例mCRPC患者中68例完成治疗周期,8例终止治疗;68例治疗后T-PSA下降率≥50%的患者共38例,PSA临床治疗有效率为55.88%,58例骨痛患者中疼痛评分下降者22例,下降率为37.93%,46例实体瘤转移病灶可测量者根据RECIST评估缓解率为32.61%;治疗中白细胞下降、中性粒细胞减少、胃肠道反应和疲乏等常见不良反应3~4级发生率分别为15.85%、15.92%、28.06%和18.29%,患者上述毒副反应均可耐受。结论:培美曲塞联合奥沙利铂二线化疗治疗多西他赛联合泼尼松治疗后进展为mCRPC的临床效果较好,且毒副作用较低,安全性较高,值得在临床上推广和使用。
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关键词:
- 培美曲塞 /
- 奥沙利铂 /
- 转移性去势抵抗性前列腺癌 /
- 临床观察
Abstract: Objective: To observe the clinical efficacy and safety of second-line chemotherapy of pemetrexed combined with oxaliplatin in the treatment of metastatic castration-resistant prostate cancer (mCRPC) after treatment of docetaxel. Method: Eighty-two patients with mCRPC after treatment of docetaxel and prednisone in our hospital from January 2012 to January 2015 were selected. All patients were treated with pemetrexed combined with oxaliplatin. The clinical effects and safety of medication after treatment were observed. Result: Sixty-eight patients completed the treatment cycle and 8 patients were discontinued; 38 patients had a decrease of T-PSA≥50% after treatment. The effective rate of PSA was 55.88%, and 58 patients had bone pain. Twenty-two patients with reduced pain scores were included in the study, and the rate of decline was 37.93%. Forty-six patients with measurable solid metastases could be measured with a remission rate of 32.61% according to RECIST. The incidence of grade 3 to 4 common adverse reactions such as leukopenia, neutropenia, gastrointestinal reactions and fatigue during treatment were 15.85%, 15.92%, 28.06%, and 18.29%, respectively. However, these toxic and side effects were tolerable.Conclusion: The second-line chemotherapy of pemetrexed combined with oxaliplatin for the treatment of mCRPC after treatment of docetaxel combined with prednisone has better clinical efficacy, lower toxic and side effects, and higher safety. It is worthy of promotion and use in clinical practice. -
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