JU：推迟生化复发性前列腺癌的雄激素剥夺治疗时机？

2021-09-07 泌尿小王 MedSci原创

在生化复发性前列腺癌(BCR)患者中进行早期持续雄激素剥夺治疗(ADT)的实践，是一种未经证实的具有显著长期毒性的治疗范式。ADT的副作用以及高昂的成本都会降低患者的生活质量。延迟治疗是否影响疗效？

在生化复发性前列腺癌(BCR)患者中进行早期持续雄激素剥夺治疗(ADT)的实践，是一种未经证实的具有显著长期毒性的治疗范式。ADT的副作用以及高昂的成本都会降低患者的生活质量。一项研究显示连续ADT和间歇ADT的治疗，在总生存期(OS)方面，间歇ADT并不逊于连续ADT，但并没有说明是否应该完全推迟ADT。推迟治疗ADT是否真的不影响患者的疗效依然有待研究。

《The Journal of Urology》最近发表的一项回顾性研究显示：推迟ADT可能不影响患者的生存时间。

方法

纳入标准

(1)接受前列腺癌根治术（RP）

(2)10个月内PSA翻倍

排除标准

转移前已经开始ADT的患者被排除在外包括接受辅助放疗或补救性ADT的患者

评估指标

（1）总生存时间

（2）无远处转移生存

结果

BCR复发患者中前列腺特异抗原倍增时间< 6个月和10个月并延迟ADT的两组患者无转移生存中位时间分别是144个月和192个月,中位总存时间168个月和204个月。

这些结果与当时接受抗雄激素试验中治疗的nmCRPC患者估计生存时间一致。

结论

BCR患者推迟激素治疗直到转移，总体生存期相当长，并且早期开始对生化复发进行持续的雄激素剥夺治疗，可能不会显著提高总体生存期。

文献来源：

Marshall CH, Chen Y, Kuo C,et al. Timing of Androgen Deprivation Treatment for Men with Biochemical Recurrent Prostate Cancer in the Context of Novel Therapies. J Urol. 2021 Sep;206(3):623-629. doi: 10.1097/JU.0000000000001797. Epub 2021 May 18. PMID: 34003011.

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#插入话题

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2021-12-11 zhaozhouchifen

#雄激素剥夺#

31 0
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2022-08-04 hb2008ye

#复发性#

0 0
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2021-09-09 jktdtl

#生化复发#

37 0
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2021-09-09 oliver175

#雄激素剥夺治疗#

44 0
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2021-09-07 misszhang

前列腺癌相关研究，学习了，谢谢梅斯

40 0
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2021-09-07 misszhang

前列腺癌相关研究，学习了，谢谢梅斯

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