PSA倍增时间对去势抵抗性前列腺癌患者多西他赛化疗后总生存期的影响

戴波; 瞿元元; 孔蕴毅; 叶定伟; 姚旭东; 张世林; 张海梁; 马春光

PSA倍增时间对去势抵抗性前列腺癌患者多西他赛化疗后总生存期的影响

- 1. 复旦大学附属肿瘤医院泌尿外科(上海, 200032);
- 2. 复旦大学上海医学院肿瘤学系;
- 3. 复旦大学附属肿瘤医院病理科
基金项目:
复旦大学"985工程"三期肿瘤研究项目Ⅱ（编号985Ⅲ-YFX0102）；上海市科委2012年度国际学术合作交流项目（编号12410709300）；上海市科委2012年度医学引导项目（编号124119a7300）

详细信息

通讯作者: 叶定伟,E-mail:dwyli@yahoo.com.cn

中图分类号: R737

收稿日期: 2012-08-30

Prognostic value of prostate-specific antigen doubling time for patients with metastatic castration-resistant prostate cancer treated with docetaxel-based chemotherapy

- 1. Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China;
- 2. Department of Oncology, Fudan University Shanghai Medical College;
- 3. Department of Pathology, Fudan University Shanghai Cancer Center

More Information

Corresponding author: YE Dingwei, E-mail: dwyli@yahoo.com.cn

Received Date: 30 August 2012

摘要

摘要: 目的：探讨化疗前PSA倍增时间（PSADT）对接受多西他赛化疗的转移性去势抵抗性前列腺癌（mCRPC）患者总生存期（OS）的影响。方法：回顾性分析2005年11月~2011年9月接受多西他赛化疗的115例mCRPC患者资料。115例患者均有骨转移，其中16例患者伴有内脏器官转移。115例随访45（2~74）个月，对可能影响化疗疗效的因素进行单因素生存分析，并对其中有统计学意义的指标进行多因素分析。生存函数分析运用Kapian-Meier法，采用Log-rank法进行显著性检验。结果：至随访截止日期，115例中87例死亡，28例生存。接受多西他赛化疗1~16个疗程，平均6个疗程。全组患者中位OS为（17.0±1.9）个月。单因素生存分析显示：化疗前基线PSA值、化疗前PSADT、基线血红蛋白（Hb）浓度、ECOG评分、激素敏感时间及化疗周期数与mCRPC患者多西他赛化疗后OS相关。化疗前PSADT<46.3 d和PSADT ≥ 46.3 d组中位OS分别为（14.0±2.1）个月和（23.0±2.2）个月（差异有统计学意义，P<0.01）。结论：化疗前PSADT、基线Hb浓度、激素敏感时间及化疗周期数为mCRPC患者多西他赛化疗后OS的独立预后因素。
- 去势抵抗性前列腺癌 /
- 多西他赛 /
- 预后 /
- 总生存期 /
- PSA倍增时间
Abstract: Objective: To evaluate the potential value of prostate-specific antigen doubling time (PSADT) in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with docetaxel-based thermotherapy. Method: We retrospectively analyzed the data of 115 consecutive Chinese patients with mCRPC received docetaxel chemotherapy in our institution from Nov. 2005 to Sep. 2011. All 115 patients have bone metastasis, and 16 cases were simultaneously observed to have the presence of visceral metastasis including lung (9 cases), bladder (4 cases), liver (2 cases) and brain (1 case). We retrospectively collected the variables including patient characteristics at diagnosis and characteristics before the start of chemotherapy. All laboratory analyses were performed in the same laboratory. Survival analysis was performed using Kaplan-Meier curves, and the differences in overall survival rates were assessed using the log-rank test. Only variables that were statistically significant in the univariate analysis (P<0.05) were included in the multivariate model.Result: The follow-up was performed until April 30, 2012, and median follow-up time was 45.0 months, ranging from 2.0 to 74.0 months. During the follow-up period, 87 of 115 patients (75.7%) died and the median OS for the entire cohort was 17.0 months, ranging from 2.0 to 46.0 months. The average cycles of chemotherapy was 6, ranging from 1 to 16. The univariate analysis identified a total of 6 statistically significant predictors of OS:baseline serum PSA level, PSADT, baseline hemoglobin (Hb) concentration, ECOG PS, time to castration resistance and cycles of chemotherapy. Subsequent multivariate analysis reserved PSADT, baseline Hb concentration, time to castration resistance and cycles of chemotherapy as independent prognostic factors for OS. The median OS for patients with PSADT<46.3 days and those with PSADT ≥ 46.3 days were 14.0 months and 23.0 months, respectively (P<0.01). Conclusion: This retrospective analysis has demonstrated that PSADT, baseline Hb concentration, time to castration resistance and cycles of chemotherapy could provide independent prognostic information of OS in Chinese patients with mCRPC treated with docetaxel. They can be used to optimize management of mCRPC.
- castration-resistant prostate cancer /
- docetaxel /
- prognosis /
- overall survival /
- prostate-specific antigen doubling time

HTML全文

参考文献(10)

[1]	Dai B, Ye D W, Kong Y Y, et al. Individualized prostate biopsy strategy for Chinese patients with different prostate-specific antigen levels[J]. Asian J Androl, 2008, 10(2):325-331.
[2]	叶定伟,朱一平. 激素抵抗性前列腺癌的治疗选择[J]. 现代泌尿外科杂志, 2011, 16(1):6-9.
[3]	林国文, 姚旭东, 叶定伟. PSA倍增时间评估前列腺癌进展的临场应用现状[J]. 国际泌尿系统杂志, 2008, 28(3):304-308.
[4]	Teeter A E, Presti J C Jr, Aronson W J, et al. Does PSADT after radical prostatectomy correlate with overall survival?——a report from the SEARCH database group[J]. Urology, 2011, 77:149-153.
[5]	Armstrong A J, Garrett-Mayer E S, Yang Y C, et al. A contemporary prognostic nomogram for men with hormone-refractory metastatic prostate cancer:a TAX327 study analysis[J]. Clin Cancer Res, 2007, 13:6396-6403.
[6]	Tannock I F, de Wit R, Berry W R, et al. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer[J]. N Engl J Med, 2004, 351:1502-1512.
[7]	Petrylak D P, Tangen C M, Hussain M H, et al. Docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer[J]. N Engl J Med, 2004, 351:1513-1520.
[8]	Petrylak D P. The treatment of hormone-refractory prostate cancer:docetaxel and beyond[J]. Rev Urology, 2006, 8:48-55.
[9]	Tomioka S, Shimbo M, Amiya Y, et al. Significance of prostate specific antigen-doubling time on survival of patients with hormone refractory prostate cancer and bone metastasis:Analysis on 56 cases of cancer-specific death[J]. Int J Urol, 2007, 14:123-127.
[10]	Warner J N, Nunez R N, Mmeje C O, et al. Impact of margin status at 37 months after robot assisted radical prostatectomy[J]. Can J Urol, 2011, 18:6043-6049.