恩杂鲁胺联合多西他赛治疗老年转移性前列腺癌的效果  

Effect and Prognosis of Enzalutamide Combined with Docetaxel in the Treatment of Metastatic Prostate Cancer in the Elderly

作　　者：李少克 李武学[2] 范世鹏 赵琪[1] LI Shaoke;LI Wuxue;FAN Shipeng;ZHAO Qi(Nanyang First People's Hospital,Nanyang 473000,Henan,China;The Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,China)

机构地区：[1]南阳市第一人民医院,河南南阳473000 [2]郑州大学第二附属医院,河南郑州450000

出　　处：《中国药物滥用防治杂志》2025年第1期85-88,95,共5页Chinese Journal of Drug Abuse Prevention and Treatment

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20190322)。

摘　　要：目的:探讨恩杂鲁胺联合多西他赛治疗老年转移性前列腺癌的效果及预后。方法:选取2021年9月—2022年6月南阳市第一人民医院收治的58例老年转移性前列腺癌患者作为研究对象,按随机数字表法分为治疗组与对照组,各29例。两组患者均进行雄激素阻断治疗(ADT),对照组在此基础上口服恩杂鲁胺,治疗组在对照组基础上给予多西他赛化疗,并联合服用泼尼松。记录两组患者的临床疗效、总体生存时间(OS)、无进展生存时间(PFS)及不良反应发生情况;比较两组治疗前后血清前列腺特异抗原(PSA)、总睾酮(TT)、血管内皮生长因子(VEGF)水平。结果:治疗后,治疗组客观缓解率(ORR)高于对照组(P<0.05);治疗组PSA、TT水平均低于对照组(P<0.05);对照组不良反应发生率与治疗组比较,差异无统计学意义(P>0.05);治疗组OS和PFS高于对照组,经Log-rank检验差异均有统计学意义(P<0.05);Cox多因素回归显示,PSA、Gleason评分是影响老年转移性前列腺癌患者预后的独立危险因素(P<0.05)。结论:恩杂鲁胺联合多西他赛治疗可有效降低老年转移性前列腺癌患者的血清因子水平,临床疗效及安全性较好。PSA和Gleason评分则是影响老年转移性前列腺癌预后不良的独立危险因素。Objective:To investigate the effect and prognosis of enzalutamide combined with docetaxel in the treatment of metastatic prostate cancer in the elderly.Methods:A total of 58 elderly patients with metastatic prostate cancer admitted to Nanyang First People's Hospital from September 2021 to June 2022 were selected as the research objects,and they were divided into treatment group and control group according to the random number table method,with 29 patients in each group.Both groups were treated with androgen deprivation therapy(ADT).On this basis,the control group was given oral administration of enzalutamide,and the treatment group was given docetaxel chemotherapy combined with prednisone on the basis of the control group.The clinical efficacy,overall survival(OS),progression-free survival(PFS)and adverse reactions of the two groups were recorded.The levels of serum prostate specific antigen(PSA),total testosterone(TT)and vascular endothelial growth factor(VEGF)were compared between the two groups before and after treatment.Results:After treatment,the objective remission rate(ORR)in the treatment group was higher than that in the control group(P<0.05).The levels of PSA and TT in the treatment group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the control group and the treatment group(P>0.05).The OS and PFS of the treatment group were higher than those of the control group,and the differences were statistically significant by Log-rank test(P<0.05).Cox multivariate regression showed that PSA and Gleason score were independent risk factors affecting the prognosis of elderly patients with metastatic prostate cancer(P<0.05).Conclusion:Enzalutamide combined with docetaxel can effectively reduce the serum factor levels in elderly patients with metastatic prostate cancer,with good clinical efficacy and safety.PSA and Gleason score are independent risk factors for poor prognosis in elderly patients with metastatic prostate cancer.

关 键 词：转移性前列腺癌 恩杂鲁胺 多西他赛 预后因素 

分 类 号：R737.25[医药卫生—肿瘤]