以多西他赛为基础的新辅助化疗在前列腺癌中的应用进展  

Docetaxel-based neoadjuvant chemotherapy before radical prostatectomy for locally advanced prostate cancer: a systematic review

作　　者：杨雄 金泓宇 宫丽娜[1] 徐航 谭平[1] 邱实[1] 林天海[1] 柳良仁[1] 杨璐[1] 魏强[1] YANG Xiong;JIN Hongyu;GONG Lina;XU Hang;TAN Ping;QIU Shi;LIN Tianhai;LIU Liangren;YANG Lu;WEI Qiang(Department of Urology/Institute of Urology,West China Hospital,Sichuan University.Chengdu,610041,China;Department of Urology,Chengdu Seventh People's Hospital;West China School of Medicine,Sichuan University)

机构地区：[1]四川大学华西医院泌尿外科四川大学华西医院泌尿外科研究所国家老年疾病临床医学研究中心,成都610041 [2]成都市第七人民医院泌尿外科 [3]四川大学华西临床医学院

出　　处：《临床泌尿外科杂志》2021年第2期120-125,共6页Journal of Clinical Urology

基　　金：国家老年疾病临床医学研究中心(四川大学华西医院)资助(No:Z2018C01);国家重点研发计划(No:SQ2017YFSF090096);国家自然科学基金(No:81770756);中国博士后科学基金面上资助(No:2017M612971);四川省科技计划国际合作项目(No:2017HH0063);四川大学华西医院专职博士后研发基金(No:2018HXBH042)。

摘　　要：目的:系统的评价以多西他赛为基础的新辅助化疗在前列腺癌患者术前应用的有效性、安全性及可行性,为临床诊疗提供依据。方法:本文以中国知网、万方数据库、PubMed数据库中查找的20篇相关文献为基础进行系统评价。纳入文献利用GRADE证据分级方法对证据质量进行评价,经过纳入排除标准严格筛选,共纳入619例患者进行研究,使用STATA14.2软件对提取出来的数据进行分析。结果:43例(6.9%)不能耐受新辅助化疗退出实验,其余患者均能较好的耐受新辅助化疗;在PSA反应方面,单独应用多西他赛新辅助化疗的111例中,29例PSA水平下降>50%;在联合运用ADT治疗的214例患者中,144例患者PSA水平下降>50%,在长期生存方面,在随访期间(中位随访13~141.6个月)35.7%~73.3%患者达到无疾病生存,合并统计总体无病生存率为52.9%(95%CI 46.9%~59.7%)。结论:以多西他赛为基础的新辅助化疗对高危前列腺癌是安全、有效并且可行的。Objective: To systematically evaluate the efficacy, safety and feasibility of docetaxel-based neoadjuvant chemotherapy in preoperative treatment of prostate cancer patients, and to provide evidence for clinical diagnosis and treatment. Methods: This paper conducted systematic evaluation based on 20 relevant literature searched in CNKI, WANFANG database and PubMed database. In the included literature, the quality of evidence was evaluated by GRADE evidence grading method. A total of 619 patients were included for the study after strict screening of inclusion and exclusion criteria, and the extracted data were analyzed by STATA14.2 software. Results: Forty-three(6.9%) patients could not tolerate neoadjuvant chemotherapy and withdrew from the experiment, while the rest of the patients could tolerate neoadjuvant chemotherapy well. In terms of PSA response, 29 of 111 patients treated with docetaxel neoadjuvant chemotherapy alone had PSA level reduction of more than 50%. Of the 214 patients combined with ADT therapy, PSA level decreased by more than 50% in 144 patients. In terms of long-term survival, patients achieved disease-free survival during the follow-up period(median follow-up period of 13-141.6 months) of 35.7% to 73.3%. Combined statistics showed an overall disease-free survival rate of 52.9%(95%CI 46.9% to 59.7%). Conclusion: Docetaxel-based neoadjuvant chemotherapy is safety, effective and feasible for prostate cancer.

关 键 词：前列腺癌 新辅助化疗 多西他赛 根治性前列腺切除 

分 类 号：R737.25[医药卫生—肿瘤]