阿比特龙联合泼尼松治疗高危高瘤负荷转移性去势抵抗性前列腺癌1例报道并文献复习  

Abiraterone combined with prednisone in the treatment of high-risk high-tumor load metastatic castration-resistant prostate cancer:a case report and literature review

作　　者：赵亚伟[1] 汤磊[1] 马旺[1] 李志坤[1] 谢燚 李前跃[1] ZHAO Yawei;TANG Lei;MA Wang;LI Zhikun;XIE Yi;LI Qianyue(Department of Urology,Xinjiang Production and Construction Crops Hospital(Second Affiliated Hospital,School of Medicine,Shihezi University),Urumqi 830002;Department of Urology,Peking Union Hospital,Chinese Academy of Medical Sciences,Beijing 100010,China)

机构地区：[1]新疆生产建设兵团医院(石河子大学医学院第二附属医院)泌尿外科,新疆乌鲁木齐830002 [2]中国医学科学院北京协和医院泌尿外科,北京100010

出　　处：《现代泌尿外科杂志》2023年第3期192-196,共5页Journal of Modern Urology

基　　金：兵团医院青年基金项目(No.2021008);兵团财政科技计划项目(No.2021AB036);兵团科技攻关项目(No.2019AB033)。

摘　　要：目的观察阿比特龙(AA)治疗转移性去势抵抗性前列腺癌(mCRPC)患者的疗效。方法分析1例初诊为高危、高瘤负荷mHSPC患者的临床资料,应用手术+内分泌治疗方案观察疾病演变,并进行文献复习。结果患者经腹腔镜下前列腺根治性切除+6个月比卡鲁胺联合雄激素剥夺治疗(ADT),总前列腺特异性抗原(tPSA)降至最低0.51 ng/mL,后逐月升高,遂于第8个月调整治疗予以国产阿比特龙(商品名:晴可舒)联合泼尼松+ADT治疗,4个月后tPSA持续升高至12.39 ng/mL,诊断为mCRPC。于第11个月再次调整治疗予原研阿比特龙(商品名:泽珂)联合泼尼松+ADT治疗,2个月后tPSA迅速下降至0.17 ng/mL。目前治疗14个月,tPSA维持在0.12 ng/mL左右,全身发射型计算机断层显像(ECT)检查提示骨转移灶范围减小或部分区域核素浓聚转为浅淡,患者无明显不良反应。结论原研阿比特龙联合泼尼松+ADT治疗mCRPC患者,PSA下降迅速,应答良好,不仅可显著降低PSA水平,而且明显减缓骨转移进展,减轻疼痛症状,无明显不良反应,长期疗效尚需进一步观察。Objective To observe the efficacy of abiraterone(AA)in the treatment of metastatic castration-resistant prostate cancer(mCRPC).Methods The clinical data of a newly diagnosed metastatic hormone sensitive prostate cancer(mHSPC)patient with high risk and high tumor load were analyzed.After operation and endocrine therapy,the disease evolution was observed.Relevant literature was reviewed.Results After laparoscopic radical prostatectomy,6-month bicalutamide and androgen deprivation therapy(ADT),the total prostate specific antigen(tPSA)was reduced to the lowest of 0.51 ng/mL,and then increased month by month.After domestic abiraterone(trade name:Qingkeshu)in the 8th month was administered for 4 months,tPSA continued to increase to 12.39 ng/mL.The case was then diagnosed as mCRPC.The treatment was adjusted again in the 11th mouth and the patient received AA(trade name:Zeke)combined with prednisone and ADT,and tPSA decreased to 0.17 ng/mL 2 months later.After 14 months of treatment,tPSA remained at about 0.12 ng/mL.Systemic ECT examination indicated that the range of bone metastases decreased and some areas of nuclide concentration turned shallow without obvious adverse reactions.Conclusion AA combined with prednisone and ADT can produce rapid decline in PSA and a good response in mCRPC patients.It can also significantly slow the progression of bone metastasis and relieve pain symptoms without obvious adverse reactions.Long-term efficacy needs further observation.

关 键 词：转移性去势抵抗性前列腺癌 阿比特龙 前列腺特异性抗原 治疗 

分 类 号：R737.25[医药卫生—肿瘤]