J Sex Med:枸橼酸西地那非与接受放射治疗前列腺癌患者的生化复发风险:一项随机对照试验的事后分析

2021-08-04 AlexYang MedSci原创

枸橼酸西地那非已证明在前列腺放射治疗(RT)的同时和之后对性功能有保护作用,但一些证据表明,前列腺根治术后服用西地那非患者的生化复发(BCR)风险增加。

枸橼酸西地那非已证明在前列腺放射治疗(RT)的同时和之后对性功能有保护作用,但一些证据表明,前列腺根治术后服用西地那非患者的生化复发(BCR)风险增加。

近期,有研究人员评估了西地那非的使用是否与接受前列腺RT患者的BCR风险增加有关,他们对一项随机安慰剂对照试验(RPCT)进行了二次分析,该试验将枸橼酸西地那非与安慰剂的治疗结局在前列腺RT期间和之后进行了比较。

研究群体由研究人员所在机构开始接受放射治疗的前列腺癌患者组成,这些患者参加了研究人员的多机构RPCT,比较了6个月的西地那非每天50毫克与安慰剂治疗,随访时间为24个月,并允许进行雄性激素阻断治疗(ADT)。前列腺癌的预后风险分组不是排除标准,但大多数研究参与者都有低或中度风险的前列腺癌。统计分析采用Kaplan-Meier图和log-rank检验。

研究人员共对162名男性的数据进行了分析。其中9名男性的PSA随访数据不足,其余153名男性纳入最终报告中。参与者的中位年龄为61岁。在8.3年的中位随访中(范围:3.0-12.2),西地那非和安慰剂组分别有5/94(5.3%)和2/59(3.4%)患者发生BCR。所有患者的6年无BCR生存率为98.8%,西地那非组为98.1%,而安慰剂组为100%。所有患者的10年无BCR生存率为94.4%,西地那非组群为95.6%,安慰剂组群为92.9%。通过对数秩比较,西地那非组和安慰剂组的无BCR生存率没有差异(P=0.36)。

安慰剂组和西地那非组的无BCR生存

综上所述,预防性枸橼酸西地那非与放射治疗的前列腺癌患者的生化复发风险没有关系。然而,该研究无法明确得出阴性结论。该分析为临床决策提供了关于在前列腺RT期间和之后使用西地那非的安全性。研究的优势在于前瞻性、随机安慰剂对照试验中接受治疗的患者,他们的用药依从性很高。然而,研究的局限性在于分析的事后性,一些患者使用ADT,无法检测出西地那非与安慰剂组之间的BCR差异

原始出处:

Justin M Haseltine , Margaret Hopkins , Elizabeth Schofield et al. Sildenafil Citrate and Risk of Biochemical Recurrence in Prostate Cancer Patients Treated With Radiation Therapy: Post-Hoc Analysis of a Randomized Controlled Trial. J Sex Med. Jul 2021

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    2022-06-22 amyloid
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    2021-08-04 肿瘤克星

    高质量研究,读起来真爽,谢谢梅斯

    0

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    2021-08-04 misszhang

    前列腺癌相关研究,学习了,谢谢梅斯

    0

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J Urol:低碳水化合物饮食与前列腺癌的心血管和代谢综合征风险评估

代谢综合征(MetS)在美国很普遍,包括了心血管疾病(CVD)的多种风险因素,并且可能与前列腺癌有关 。此外,MetS可能与更差的前列腺癌结局有关,特别是更具侵略性的肿瘤特征和生化复发。联系MetS和

Eur Urol:磁共振成像定位对前列腺癌过度诊断和过度治疗的影响

已经有研究指出,利用磁共振成像(MRI)定位前列腺病变,将提高前列腺活检对高等级疾病的敏感性。但在MRI上发现的高级别肿瘤却在系统活检中遗漏的的临床意义有待商榷。

NEJM:过度诊断减半,能有效筛检前列腺癌!

每年大约有140万男性被诊断为前列腺癌,约37.5万男性死于该病。研究表明,及时筛查可以更早的发现疾病,从而降低前列腺癌死亡的风险。但是目前,使用前列腺特异性抗原(PSA)检测结合传统活检筛查,可能会

J Urol:美国真实世界中对转移去势抵抗性前列腺癌患者的管理

转移性前列腺癌(mPC)患者最初通常对手术或药物(雄性激素阻断疗法[ADT])去势有反应,称为转移性去势敏感前列腺癌(mCSPC),未接受ADT而发生转移的患者也认为是mCSPC(原发进展性mCSPC

Eur Urol:卡巴他赛与阿比特龙或恩杂鲁胺在老年转移性去势抵抗性前列腺癌患者中的疗效和安全性比较研究

在CARD研究(NCT02485691)中,卡巴他赛与阿比特龙/恩杂鲁胺相比,显著提高了转移去势抵抗性前列腺癌(mCRPC)患者的中位放射学无进展生存期(rPFS)和总生存期(OS),这些患者之前接受

Eur Urol Focus:无夹机器人辅助根治性前列腺切除术及对结果的影响

在进行机器人辅助前列腺根治术(RARP)时,使用手术夹对侧前列腺蒂进行无热解剖,并在盆腔淋巴结清扫术(PLND)期间进行结扎已成为手术过程的金标准。夹子的使用是为了防止无髓神经纤维和淋巴结的热损伤。