醋酸阿比特龙联合ADT治疗高危转移性激素敏感性前列腺癌的临床研究  

Clinical study of abiraterone acetate combined with androgen deprivation therapy in the treatment of high-risk metastatic hormone sensitive prostate cancer

作　　者：何源 孙毅海 黄超斌 欧阳明月 谢阳 黄慧宁 陶卫琦 黄才胜 HE Yuan;SUN Yihai;HUANG Chaobin;OUYANG Mingyue;XIE Yang;HUANG Huining;TAO Weiqi;HUANG Caisheng(Department of Urology Surgery,the Third Affiliated Hospital of Guangxi Medical University—The Second Nanning People's Hospital,Nanning 530031,Guangxi,China)

机构地区：[1]广西医科大学第三附属医院暨南宁市第二人民医院泌尿外科,广西南宁530031

出　　处：《右江医学》2024年第10期883-889,共7页Chinese Youjiang Medical Journal

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(20210443)。

摘　　要：目的探讨醋酸阿比特龙联合雄激素剥夺治疗(ADT)在治疗高危转移性激素敏感性前列腺癌(mHSPC)中的疗效及安全性。方法纳入30例新诊断的高危mHSPC患者,并随机分为观察组与对照组,每组15例。观察组接受醋酸阿比特龙联合泼尼松与醋酸戈舍瑞林治疗,而对照组则接受比卡鲁胺联合醋酸戈舍瑞林治疗。对比两组患者治疗后的血清前列腺特异性抗原(PSA)水平、睾酮水平、碱性磷酸酶(ALP)水平、PSA进展及不良反应发生情况。结果(1)观察组患者在治疗后3、6、9、12个月的PSA及睾酮水平均低于对照组(P<0.05)。(2)两组患者血清ALP与PSA在治疗6个月后呈正相关(P=0.046),而在其他时间点无统计学相关性(P>0.05)。治疗12个月后,观察组与对照组均观察到血清ALP水平下降,但组间差异无统计学意义(P>0.05)。(3)随访12个月内,观察组患者未出现PSA明显进展,而对照组有5例患者出现PSA进展并达到转移性去势抵抗性前列腺癌(mCRPC)诊断标准,差异有统计学意义(P<0.05)。(4)随访12个月内,观察组与对照组分别有3例及2例患者出现不良反应,但均无患者因不良反应暂停或更换治疗方案,差异无统计学意义(P>0.05)。结论醋酸阿比特龙联合ADT治疗方案相较于传统比卡鲁胺联合ADT治疗方案,在降低PSA及睾酮水平方面更为迅速和深入,能够延缓进展至mCRPC的时间,且未显著增加患者的不良反应发生率。Objective To investigate the efficacy and safety of abiraterone acetate combined with androgen deprivation therapy(ADT)in the treatment of high-risk metastatic sensitive prostate cancer(mHSPC).Methods 30 newly diagnosed high-risk mHSCP patients were included and randomly divided into observation group and control group,with 15 cases in each group.The observation group were treated with abiraterone acetate combined with prednisone and goserelin acetate,while the control group were treated with bicalutamide combined with goserelin acetate.And then,serum prostate-specific antigen(PSA)levels,testosterone levels,alkaline phosphatase(ALP)levels,PSA progression and the occurrence of adverse reactions after treatment were compared between the two groups.Results(1)The PSA and testosterone levels of the observation group were lower than those of the control group at 3,6,9,and 12 months after treatment(P<0.05).(2)There was a positive correlation between serum ALP and PSA levels in the two groups after 6 months of treatment(P=0.046),while there was no statistical correlation at other time points(P>0.05).After 12 months of treatment,both the observation group and the control group could be observed a decrease in serum ALP levels,but difference was not statistically significant between groups(P>0.05).(3)Within 12 months of follow-up,no significant progression of PSA was observed in the observation group,while 5 patients in the control group showed PSA progression and met the diagnostic criteria of metastatic castration-resistant prostate cancer(mCRPC),and difference was statistically significant(P<0.05).(4)Within 12 months of follow-up,adverse reactions occurred in 3 and 2 patients in the observation group and the control group,respectively,and no patients suspended or changed treatment regimen due to adverse reactions,and the difference was not statistically significant(P>0.05).Conclusion Compared with traditional bicalutamide combined with ADT regimen,abiraterone acetate combined with ADT in the treatment of high-risk mHSPC

关 键 词：转移性激素敏感性前列腺癌 醋酸阿比特龙 比卡鲁胺 前瞻性研究 

分 类 号：R737.25[医药卫生—肿瘤]