晚期转移性前列腺癌内分泌治疗分析  

Analysis of hormonal therapy for advanced metastatic prostate cancer

作　　者：马春光[1] 叶定伟[1] 姚旭东[1] 张世林[1] 戴波[1] 张海梁[1] 朱耀[1] 沈益君[1] 朱一平[1] 施国海[1] 秦晓健[1] 林国文[1] 杨立峰[1] 杨柏帅[1] 肖文军[1] 

机构地区：[1]复旦大学附属肿瘤医院泌尿外科复旦大学上海医学院肿瘤学系,上海200032

出　　处：《中华泌尿外科杂志》2009年第12期831-833,共3页Chinese Journal of Urology

摘　　要：目的 探寻晚期转移性前列腺癌内分泌治疗效果及生存预后的预测因子。方法1996年12月至2008年3月收治前列腺癌患者820例，其中晚期转移性前列腺癌患者364例，均接受内分泌治疗并且具有完整临床病理资料。364例患者，末次随访时间2008年3月31日，中位随访时间24（3～135）个月。患者随访期间进展为雄激素非依赖性前列腺癌250例。对364例患者的内分泌治疗效果及生存预后进行分析。生存函数分析运用Kaplan-Meier法，单因素和多因素分析运用Cox回归，采用Log—rank法进行显著性检验。结果364例患者内分泌治疗有效率98％（357／364），中位无进展生存时间20（1～113）个月，1、2、3年无进展生存率分别为69％、39％、27％。多因素分析结果显示：基线PSA〉20ng／ml（FIR2．279，95％CI1．239-4．190）、临床分期（FIR6．879，95％CI2．48019．083）、内分泌治疗过程中PSA最低值≥1ng／ml（HR6．838，95％CI4．26310．967）和达到PSA最低值时间≤5个月（HR0．366，95％CI0．236～0．570）为晚期转移性前列腺癌内分泌治疗无进展生存时间的不良预后因素。结论基线PSA、临床分期、内分泌治疗过程中PSA最低值和达到PSA最低值时间为晚期转移性前列腺癌内分泌治疗无进展生存时间的独立预后因素。Objective To find the predictive factors that related to the effect of hormonal therapy and the survival of advanced metastatic prostate cancer. Methods Three hundred and Sixty-four cases of metastatic prostate cancer were treated with hormonal therapy in Cancer Hospital Fudan University in Shanghai from December 1996 to March 2008. The patients were followed up to the 31 March 2008 and the median follow-up time was 24 months. Two hundred and fifty cases have progressed into the stage of hormonal independent. The statistic software used in this study was SPSS 15.0. Cumulative survival was analyzed by Kaplan-Meier method. Cox regression was used for univariate and multivariate analysis. Log-rank method was used for the significance test. The statistical difference was accepted when the P-value was lower than 0.05. Results The effective rate of hormonal therapy for advanced metastatic prostate cancer was 98 %. The median time of progression free survival of hormonal therapy was 20 months, and the one-year, two-year, three-year progression free survival rate was 69%, 39%, 27%, respectively. The survival analysis indicated that baseline PSA level more than 20ng/ml, with visceral organ metastasis, the PSA nadir more than 1ng/ml during hormonal therapy, the time from the start of hormonal therapy to the PSA nadir less than 5 months were poor prognostic factors of progression free survival. Conclusions The baseline PSA level, clinical stage, the PSA nadir during hormonal therapy and the time form the start of hormonal therapy to the PSA nadir could be the factors that predict the progression free survival time during hormonal therapy.

关 键 词：前列腺肿瘤 癌 内分泌治疗 预后 

分 类 号：R686[医药卫生—骨科学]