中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2010年
12期
847-851
,共5页
马春光%叶定伟%姚旭东%张世林%戴波%张海梁%朱耀%沈益君%朱一平%施国海%秦晓健%林国文%肖文军%杨立峰%杨柏帅%曹达龙
馬春光%葉定偉%姚旭東%張世林%戴波%張海樑%硃耀%瀋益君%硃一平%施國海%秦曉健%林國文%肖文軍%楊立峰%楊柏帥%曹達龍
마춘광%협정위%요욱동%장세림%대파%장해량%주요%침익군%주일평%시국해%진효건%림국문%초문군%양립봉%양백수%조체룡
前列腺肿瘤%癌%雄激素类
前列腺腫瘤%癌%雄激素類
전렬선종류%암%웅격소류
Prostatic neoplasms%Carcinoma%Androgens
目的 寻找预测抗雄激素药物撤退治疗雄激素非依赖性晚期转移性前列腺癌有效性的相关因素.方法 晚期转移性前列腺癌患者347例,均接受最大程度雄激素阻断治疗.其中失效进展为雄激素非依赖性前列腺癌(AIPC)237例,接受抗雄激素药物撤退治疗90例.对90例患者进行随访,末次随访时间2009年9月30日.将内分泌治疗前基线血清PSA、Gleason评分(GS)、临床分期、去势方案、抗雄激素药物方案、内分泌治疗过程中血清PSA最低值、达到PSA最低值时间、进展为AIPC时PSA速率(PSAV)、进展为AIPC时PSA倍增时间(PSADT)、内分泌治疗有效时间、进展为AIPC时年龄、抗雄激素药物撤退治疗前PSA作为预测抗雄激素药物撤退治疗是否有效的预测因素,行Logistic单因素及多因素回归分析.结果 90例患者中具有完整随访资料87例,其中有效17例(19.5%),无效70例(80.5%).至末次随访时,失效14例,仍有效3例.抗雄激素药物撤退治疗中位有效时间4个月.单因素分析结果显示,进展为AIPC时PSAV(P=0.033)、进展为AIPC时PSADT(P=0.009)和抗雄激素药物撤退治疗前PSA(P=0.002)为抗雄激素药物撤退治疗有效性的预测因素.多因素分析结果显示:进展为AIPC时PSAV(P=0.042)和PSADT(P=0.036)为抗雄激素药物撤退治疗有效性的独立预测因素.结论 进展为AIPC时PSAV和PSADT为预测抗雄激素药物撤退治疗有效性的独立预测因素.
目的 尋找預測抗雄激素藥物撤退治療雄激素非依賴性晚期轉移性前列腺癌有效性的相關因素.方法 晚期轉移性前列腺癌患者347例,均接受最大程度雄激素阻斷治療.其中失效進展為雄激素非依賴性前列腺癌(AIPC)237例,接受抗雄激素藥物撤退治療90例.對90例患者進行隨訪,末次隨訪時間2009年9月30日.將內分泌治療前基線血清PSA、Gleason評分(GS)、臨床分期、去勢方案、抗雄激素藥物方案、內分泌治療過程中血清PSA最低值、達到PSA最低值時間、進展為AIPC時PSA速率(PSAV)、進展為AIPC時PSA倍增時間(PSADT)、內分泌治療有效時間、進展為AIPC時年齡、抗雄激素藥物撤退治療前PSA作為預測抗雄激素藥物撤退治療是否有效的預測因素,行Logistic單因素及多因素迴歸分析.結果 90例患者中具有完整隨訪資料87例,其中有效17例(19.5%),無效70例(80.5%).至末次隨訪時,失效14例,仍有效3例.抗雄激素藥物撤退治療中位有效時間4箇月.單因素分析結果顯示,進展為AIPC時PSAV(P=0.033)、進展為AIPC時PSADT(P=0.009)和抗雄激素藥物撤退治療前PSA(P=0.002)為抗雄激素藥物撤退治療有效性的預測因素.多因素分析結果顯示:進展為AIPC時PSAV(P=0.042)和PSADT(P=0.036)為抗雄激素藥物撤退治療有效性的獨立預測因素.結論 進展為AIPC時PSAV和PSADT為預測抗雄激素藥物撤退治療有效性的獨立預測因素.
목적 심조예측항웅격소약물철퇴치료웅격소비의뢰성만기전이성전렬선암유효성적상관인소.방법 만기전이성전렬선암환자347례,균접수최대정도웅격소조단치료.기중실효진전위웅격소비의뢰성전렬선암(AIPC)237례,접수항웅격소약물철퇴치료90례.대90례환자진행수방,말차수방시간2009년9월30일.장내분비치료전기선혈청PSA、Gleason평분(GS)、림상분기、거세방안、항웅격소약물방안、내분비치료과정중혈청PSA최저치、체도PSA최저치시간、진전위AIPC시PSA속솔(PSAV)、진전위AIPC시PSA배증시간(PSADT)、내분비치료유효시간、진전위AIPC시년령、항웅격소약물철퇴치료전PSA작위예측항웅격소약물철퇴치료시부유효적예측인소,행Logistic단인소급다인소회귀분석.결과 90례환자중구유완정수방자료87례,기중유효17례(19.5%),무효70례(80.5%).지말차수방시,실효14례,잉유효3례.항웅격소약물철퇴치료중위유효시간4개월.단인소분석결과현시,진전위AIPC시PSAV(P=0.033)、진전위AIPC시PSADT(P=0.009)화항웅격소약물철퇴치료전PSA(P=0.002)위항웅격소약물철퇴치료유효성적예측인소.다인소분석결과현시:진전위AIPC시PSAV(P=0.042)화PSADT(P=0.036)위항웅격소약물철퇴치료유효성적독립예측인소.결론 진전위AIPC시PSAV화PSADT위예측항웅격소약물철퇴치료유효성적독립예측인소.
Objective To analyze the predictive factors of anti-androgen withdrawal in the treatment of androgen independent prostate cancer. Methods 347 cases of advanced metastatic prostate cancer in our prostate cancer database were filtered. All the cases were treated with maximal androgen blockade and had full pathological and clinical information. 237 cases developed to the androgen independent stage during the maximal androgen blockade treatment. Among them, 90 cases were treated with anti-androgen withdrawal. This 90 cases were followed up and the last follow-up date was 30 September 2009. The Logistic regression of univariate and multivariate analysis were used to find the predictive factors for the effectiveness of anti-androgen withdrawal, which including baseline PSA, Gleason score, clinical stage, way of castration, kind of anti-androgen, PSA nadir during maximal androgen blockade, time to PSA nadir, PSAV at the time of AIPC, PSADT at the time of AIPC, the effective duration of maximal androgen blockade, age at the time of AIPC and PSA at the initiation of anti-androgen withdrawal. Results Of the 90 cases treated with anti-androgen withdrawal, 3 cases were excluded for analysis because of the incomplete information. Among the 87 cases, 17 cases were effective with the anti-androgen withdrawal treatment while the other 70 cases were ineffective. At the last follow-up, 3 cases were still effective. The median effective duration of anti-androgen withdrawal was 4 months. The univariate analysis indicated that PSAV at the time of AIPC (P=0.033), PSADT at the time of AIPC (P=0.009) and PSA at the initiation of anti-androgen withdrawal (P=0.002)were predictive factors. The multivariate analysis indicated that PSAV (P=0.042) and PSADT at the time of AIPC (P= 0.036) were independent predictive factors for the effectiveness of anti-androgen withdrawal. Conclusions Among the androgen independent advanced metastatic prostate cancer patient, there were about 19. 5% cases effective with the anti-androgen withdrawal treatment and the median effective duration was 4 months. PSAV and PSADT at the time of AIPC were independent predictive factors for the effectiveness of anti-androgen withdrawal.
