改良Glasgow预后评分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及临床分析  

Modified Glasgow prognostic score as a prognostic factor in castrate-resistant prostate cancer treated with docetaxel-based chemotherapy and clinical analysis

作　　者：张姣[1] 翁少波[2] 王海涛[1] 杨庆[1] 杜君[1] 贾炜莹[1] 张鹏宇[1] 

机构地区：[1]天津医科大学肿瘤医院介入治疗科国家肿瘤临床医学研究中心天津市肿瘤防治重点实验室,300060 [2]华北石油管理局总医院泌尿外科

出　　处：《中华泌尿外科杂志》2015年第4期294-298,共5页Chinese Journal of Urology

摘　　要：目的 探讨改良Glasgow预后评分（modified Glasgow prognostic score,mGPS）对去势抵抗性前列腺癌（castrate-resistant prostate cancer,CRPC）患者多西他赛化疗后总生存期（overall survival,OS）的影响以及影响OS的危险因素.方法 回顾性分析2008年1月至2012年1月48例接受多西他赛化疗的CRPC患者的临床资料.根据化疗前mGPS分值将患者分为mGPS 0分、1分和2分组,比较3组患者OS的差异,对可能影响化疗疗效的因素进行单因素及多因素分析.生存函数分析采用Kaplan-Meier法,采用Log-rank法进行显著性检验.结果 本组48例均获有效随访,随访截至2014年4月,47例死亡,1例存活.mGPS 0分者30例、1分者11例、2分者7例,其OS分别为22、11、9个月,3组比较差异有统计学意义（P＜0.01）.单因素分析结果显示,基线总前列腺特异性抗原（total prostate-specific antigen,tPSA）、东部肿瘤协作组评分、化疗周期数、合并内脏转移以及PSA反应无效与预后不良有关（P＜0.05）.Cox模型多因素分析结果显示,化疗前mGPS 1～2分、基线tPSA＞60 μg/L、化疗周期数≤5个、伴内脏转移以及PSA反应无效是影响CRPC患者多西他赛化疗OS的独立危险因素.结论 mGPS是影响多西他赛化疗的CRPC患者OS的独立危险因素.Objective To explore the prognostic value of modified Glasgow prognostic score （mGPS） and risk factors in predicting overall survival （OS） in the castrate-resistant prostate cancer （CRPC） treated with docetaxel-based chemotherapy.Methods We retrospectively analyzed the data of 48 consecutive Chinese patients with CRPC received docetaxel-based chemotherapy in our institution from January 2008 to January 2012.Patients were divided into three groups according to the mGPS：0,1 and 2 score groups,and compare the OS among the three groups.Variables that were influenced the efficacy of chemotherapy were included in the univariate analysis and multivariate model.Survival analysis was performed using Kaplan-Meier curves,and the differences in overall survival rates were assessed using the Logrank test.Results The follow-up was performed until April 2014.There were 48 CRPC patients including mGPS 0 score group 30 cases,mGPS 1 score group 11 cases and mGPS 2 score 7 cases.The median OS was 22,11,9 months,respectively,P〈0.01.Univariate analysis showed that：prechemotherapy baseline total prostate-specific antigen （tPSA）,Eastern Cooperative Oncology Group （ECOG） score,the number of chemotherapy cycle,visceral metastasis and PSA response were associated with poor prognosis （P〈0.05）.Multivariate analysis showed that：prechemotherapy mGPS 1-2 score,baseline tPSA〉60 μg/L,the number of cycles of chemotherapy≤5,with visceral metastasis and PSA response in patients with CRPC were independent risk factors for prognosis in the CRPC treated with docetaxel-based chemotherapy.Conclusion mGPS is an independent risk factor for prognosis in the CRPC patients treated with docetaxel-based chemotherapy.

关 键 词：格拉斯哥预后评分 前列腺肿瘤 去势抵抗性前列腺癌 预后 多西他赛 

分 类 号：R737.25[医药卫生—肿瘤]