恩杂鲁胺、阿比特龙联合雄激素剥夺治疗转移性去势抵抗性前列腺癌的疗效及生存分析  

Efficacy and survival analysis of enzalutamide and abirateronecombined with androgen deprivation therapy(ADT)in treatment of metastatic castration-resistant prostate cancer(mCRPC)

作　　者：苟东 王全 刘蓉 刘宗梅 何秉翰 龙家才 GOU Dong;WANG Quan;LIU Rong;LIU Zongmei;HE Binghan;LONG Jiacai(Department of Urology,Bazhong Central Hospital,Bazhong Sichuan 636000,China)

机构地区：[1]巴中市中心医院泌尿外科,四川巴中636000

出　　处：《新疆医科大学学报》2025年第4期504-508,515,共6页Journal of Xinjiang Medical University

基　　金：四川省医学会医学科研课题项目(S22018)。

摘　　要：目的探究恩杂鲁胺、阿比特龙联合雄激素剥夺治疗(ADT)转移性去势抵抗性前列腺癌(mCRPC)的疗效,并进行生存分析。方法选取2022年1月至2024年1月本院收治的82例mCRPC患者,根据治疗方案分为恩杂鲁胺组(n=38)和阿比特龙组(n=44)。阿比特龙组采用ADT+阿比特龙治疗,恩杂鲁胺组采用ADT+恩杂鲁胺治疗。治疗3个月后评估临床疗效,检测患者血清前列腺特异性抗原(PSA)水平,统计治疗期间PSA缓解率及PSA最低值。观察两组药物不良反应发生率,随访统计生化无进展生存期(bPFS)及影像学无进展生存期(rPFS)。结果两组改良后的最佳总体缓解(mBOR)率分别为21.05%、11.36%,组间比较差异无统计学意义(P>0.05);与阿比特龙组比较,恩杂鲁胺组PSA缓解率升高,PSA最低值降低(P<0.05);恩杂鲁胺组Ⅲ~Ⅳ级不良反应以血糖升高、乏力/疲劳为主,阿比特龙组Ⅲ~Ⅳ级不良反应以血糖升高、低血钾及转氨酶升高为主,两组Ⅲ~Ⅳ级不良反应发生率比较(34.21%vs.36.36%)差异无统计学意义(P>0.05);恩杂鲁胺组10例生化疾病进展,10例影像学进展,阿比特龙组20例生化疾病进展,17例影像学进展;经Kaplan-Meier分析,与阿比特龙组比较,恩杂鲁胺组患者bPFS及rPFS均延长(P均<0.05)。结论恩杂鲁胺、阿比特龙联合ADT治疗mCRPC疗效相当,其中恩杂鲁胺组提高PSA缓解率、降低PSA最低值更加明显,安全性可控的同时可有效延长患者的无进展生存时间。Objective To explore the efficacy of enzalutamide and abiraterone combined with androgen deprivation therapy(ADT)in the treatment of metastatic castration-resistant prostate cancer(mCRPC)and conduct survival analysis.Methods A total of 82 patients with mCRPC admitted to the hospital from January 2022 to January 2024 were divided into enzalutamide group(n=38)and abiraterone group(n=44)according to the treatment regimen.The abiraterone group was treated with ADT+abiraterone,and the enzalutamide group was treated with ADT+enzalutamide.After 3 months of the treatment,the clinical efficacy of the patients were evaluated,the serum prostate-specific antigen(PSA)level was measured,and the PSA remission rate and the lowest PSA value during the treatment period were statistically counted.The occurrence of adverse drug reactions in the 2 groups was observed,and the biochemical progression-free survival(bPFS)and imaging progression-free survival(rPFS)were statistically counted.Results The best overall response(mBOR)after improvement was 21.05%and 11.36%,respectively,and there was no significant difference between the 2 groups(P>0.05).Compared with abiraterone group,the PSA remission rate was increased and the minimum PSA value was decreased in enzalutamide group(P<0.05).The gradeⅢ-Ⅳadverse reactions in the enzalutamide group were mainly elevated blood glucose and fatigue/fatigue,and the gradeⅢ-Ⅳadverse reactions in the abiraterone group were mainly elevated blood glucose,hypokalemia and transaminases.The incidence of gradeⅢ-Ⅳadverse reactions in the 2 groups was 34.21%and 36.36%,respectively,and there was no significant difference between the 2 groups(P>0.05).In the enzalutamide group,there were 10 cases of biochemical disease progression and 10 cases of imaging progression,and 20 cases of biochemical disease progression and 17 cases of imaging progress in the abiraterone group.Kaplan-Meier analysis showed that compared with abiraterone group,bPFS and rPFS in both enzalutamide groups were prolonged(P<0.05).Conclu

关 键 词：转移性去势抵抗性前列腺癌(mCRPC) 雄激素剥夺治疗(ADT) 恩杂鲁胺 阿比特龙 生存分析 

分 类 号：R697.3[医药卫生—泌尿科学]