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目的:探讨化疗前PSA倍增时间(PSADT)对接受多西他赛化疗的转移性去势抵抗性前列腺癌(mCRPC)患者总生存期(OS)的影响。方法:回顾性分析2005年11月～2011年9月接受多西他赛化疗的115例mCRPC患者资料。115例患者均有骨转移,其中16例患者伴有内脏器官转移。115例随访45(2～74)个月,对可能影响化疗疗效的因素进行单因素生存分析,并对其中有统计学意义的指标进行多因素分析。生存函数分析运用Kapian-Meier法,采用Log-rank法进行显著性检验。结果:至随访截止日期,115例中87例死亡,28例生存。接受多西他赛化疗1～16个疗程,平均6个疗程。全组患者中位OS为(17.0±1.9)个月。单因素生存分析显示:化疗前基线PSA值、化疗前PSADT、基线血红蛋白(Hb)浓度、ECOG评分、激素敏感时间及化疗周期数与mCRPC患者多西他赛化疗后OS相关。化疗前PSADT<46.3d和PSADT≥46.3d组中位OS分别为(14.0±2.1)个月和(23.0±2.2)个月(差异有统计学意义,P<0.01)。结论:化疗前PSADT、基线Hb浓度、激素敏感时间及化疗周期数为mCRPC患者多西他赛化疗后OS的独立预后因素。
Objective: To investigate the effect of pre-chemotherapy PSA doubling time (PSADT) on the overall survival (OS) of patients with metastatic castration-resistant prostate cancer (mCRPC) receiving docetaxel chemotherapy. Methods: The data of 115 patients with mCRPC receiving docetaxel chemotherapy from November 2005 to September 2011 were retrospectively analyzed. All 115 patients had bone metastases, of which 16 patients had visceral organ metastases. One hundred and fifteen patients were followed up for 45 months (range, 2-74 months). One-factor survival analysis was performed on the factors that may affect the curative effect of chemotherapy. Multivariate analysis was made among the statistically significant indicators. Survival function analysis using Kapian-Meier method, using Log-rank method for significance test. Results: By the deadline for follow-up, 87 of 115 patients died and 28 survived. To receive docetaxel chemotherapy 1 to 16 courses, an average of 6 courses. The median OS was (17.0 ± 1.9) months for all patients. Univariate survival analysis showed that pre-chemotherapy baseline PSA, pretreatment PSADT, baseline hemoglobin (Hb) concentration, ECOG score, hormone-sensitive time and the number of cycles of chemotherapy were associated with OS after moxifloxacin chemotherapy in mCRPC patients. The median OS of PSADT <46.3d and PSADT≥46.3d before chemotherapy were (14.0 ± 2.1) months and (23.0 ± 2.2) months, respectively (P <0.01). Conclusion: PSADT before chemotherapy, baseline Hb concentration, hormone-sensitive time and the number of chemotherapy cycles mCRPC docetaxel chemotherapy after OS independent prognostic factors.