论文部分内容阅读
目的:评估卡巴他赛治疗转移性去势抵抗性前列腺癌(mCRPC)患者中前列腺特异性抗原(PSA)闪烁的发生率和特征及其对生存时间的影响。方法:对2007年1月至2012年5月期间进行卡巴他赛二线化疗治疗的125例mCRPC患者的临床资料进行回顾性研究。收集卡巴他赛治疗前和治疗期间患者的基线特征、疾病史和PSA水平。患者的总生存期(OS)和放射/临床无进展生存期(PFS)通过Kaplan-Meier方法估计的不同PSA定义，并使用对数秩检验进行比较。结果:共125例患者纳入研究，中位PFS和OS分别为6.5和13.3个月。根据所使用的不同定义，PSA闪烁的发生率、相对振幅和PSA峰值时间以及随后的总生存期(PFS和OS)都存在差异，闪烁发生率为8.3%～30.6%，闪烁持续时间为0.6～2.6个月。闪烁后较基线值降低50%患者的中位OS和PFS与PSA即时反应患者比较，差异无统计学意义(n P＝0.96、0.46)，但优于非应答者(n P＝0.006、0.003)，与基线相比30%下降的闪烁患者的生存结果相似。n 结论:对于卡巴他赛所诱发的PSA即时反应，无论初始是否有闪烁发生，对于治疗所带来的生存率的提高都没有明显的影响。在评估PSA即时反应效果时，可以忽略在治疗前12周期间紫杉醇所诱导引起的PSA闪烁。“,”Objective:To evaluate the incidence and characteristics of PSA flare on cabazitaxel, and its impact on survival.Methods:Multicentre retrospective review of consecutive patients treated with cabazitaxel second-line chemotherapy for mCRPC was performed. Collection of baseline characteristics, disease history and PSA levels before and during cabazitaxel therapy was finished. Overall survival(OS) and radiological/clinical progression-free survival(PFS) for patient groups corresponding to different definitions of PSA flare were estimated by the Kaplan-Meier method and compared using the log-rank test.Results:Overall, 125 patients were included. Median PFS and OS were 6.5 and 13.3 months, respectively.Depending upon the definition used, flare incidence ranged from 8.3% to 30.6%.The flare lasted<2.6 months.A PSA flare followed by a 50% decrease was associated with a median PFS and OS of 11.2 and 25.2 months, respectively.Median PFS and OS for a 30% rather than 50% decrease were 10.4 and 16.5 months.These outcomes were not significantly different from those in patients with immediate PSA decreases of 50% or 30% from baseline, but were significantly better than in patients experiencing no PSA decrease(n P=0.006 and 0.003, respectively, for OS).n Conclusions:For the PSA response induced by cabataxel, no matter whether the initial scintillation occurs or not, it has no significant effect on the improvement of survival rate brought about by treatment.The taxane-induced flare during the first 12 weeks of therapy can be ignored when evaluating PSA response.