|本期目录/Table of Contents|

米托蒽醌联合沙利度胺挽救治疗经多西他赛治疗失败的晚期去势抵抗性前列腺癌的疗效观察

《现代肿瘤医学》[ISSN:1672-4992/CN:61-1415/R]

期数:
2019年20期
页码:
3644-3647
栏目:
论着(消化·泌尿系肿瘤)
出版日期:
2019-09-08

文章信息/Info

Title:
Mitoxantrone plus thalidomide salvage on advanced castration-resistant prostate cancer progressing after docetaxel treatment
作者:
田美娟1;?2;?宋相瑾1;?王 丽3;?陆 诚2;?张 佳1 ;? 谢宏俊1
1.西安交通大学第一附属医院,陕西 西安 710061;2.陕西中医药大学附属宝鸡市中医医院肿瘤血液科,陕西 宝鸡 721000;3.长安大学医院,陕西 西安 710061
Author(s):
Tian Meijuan1;?2;?Song Xiangjin1;?Wang Li3;?Lu Cheng2;?Zhang Jia1;?Xie Hongjun1
1.First Affiliated Hospital of Xi'an Jiaotong University,Shaanxi Xi'an 710061,China;2.Department of Medical Oncology and Hematology,Traditional Chinese Hospital of Baoji,Shaanxi University of Chinese Medicine Affiliated Hospital,Shaanxi Baoji 721000,China;3.Chang'an University,Shaanxi Xi'an 710061,China.
关键词:
米托蒽醌;?沙利度胺;?去势抵抗性前列腺癌;?抗血管生成治疗
Keywords:
mitoxantrone;?thalidomide;?castration-resistant prostate cancer(CRPC);?antiangiogenic therapy
分类号:
R737.25
DOI:
10.3969/j.issn.1672-4992.2019.20.021
文献标识码:
A
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目的:观察米托蒽醌联合沙利度胺挽救治疗经多西他赛治疗失败的晚期去势抵抗性前列腺癌的疗效及不良反应。方法:回顾性分析我院收治的80例经多西他赛化疗失败的晚期去势抵抗性前列腺癌患者,按治疗方法不同分为两组,观察组40例接受米托蒽醌、泼尼松联合沙利度胺方案化疗,对照组仅接受米托蒽醌、泼尼松方案化疗。每2个疗程评价疗效,计算PSA缓解率及中位进展时间、ORR及中位TTP、骨痛缓解率和不良反应。结果:80例患者均可评价疗效,观察组和对照组的PSA缓解率分别为55.0%、47.5%,中位进展时间分别为4.2个月、3.5个月,mTTP分别为4.9个月、4.1个月,骨痛缓解率分别为74.3%、51.5%,ORR均为5.0%,两组差异比较无统计学意义(P>0.05)。观察组患者的骨髓抑制、胃肠道反应发生率稍低于对照组,但差异无统计学意义(P>0.05);观察组患者的失眠、消瘦症状较对照组明显得到改善,差异有统计学意义(P<0.05)。结论:米托蒽醌、泼尼松方案挽救治疗经多西他赛治疗失败的晚期去势抵抗性前列腺癌有较好的疗效,不良反应发生率低,联合沙利度胺可进一步改善晚期患者的失眠、消瘦症状。
Abstract:
Objective:To observe the efficacy and adverse reactions of mitoxantrone plus thalidomide for advanced castration-resistant prostate cancer treated with docetaxel.Methods:80 patients with advanced castration-resistant prostate cancer were divided into two groups according to different treatment methods.Forty patients in the observation group received mitoxantrone and prednisone plus thalidomide regimen,while the control group received only mitoxantrone and prednisone.The prostate specific antigen (PSA) remission rate and median progression time,overall response rate(ORR) and median disease progression time (mTTP),bone pain relief rate and adverse reactions were calculated.Results:The PSA remission rates of the observation group and the control group were 55.0% and 47.5%,respectively,and the median progression time was 4.2 months and 3.5 months respectively.The mTTP was 4.9 months and 4.1 months respectively.The remission rate of bone pain was 74.3% and 51.5%,respectively,the ORR was 5.0%,and the difference was not statistically significant (P<0.05).The incidence of bone marrow suppression and gastrointestinal reactions in the observation group was slightly lower than that in the control group,but the difference was not statistically significant (P>0.05).The symptoms of insomnia and thinness in the observation group were significantly improved compared with the control group (P<0.05).Conclusion:The mitoxantrone and prednisone have a good effect for advanced castration-resistant prostate cancer after docetaxel treatment,and the incidence of adverse reactions is low.Combined with thalidomide can further improve insomnia and thinness.

参考文献/References

[1]YE DW.Epidemiology of prostate cancer and the incidence of disease in China [J].Chin J Surg,2006,44(6):362-364.[叶定伟.前列腺癌的流行病学和中国的发病趋势[J].中华外科杂志,2006,44(6):362-364.]
[2]Tannock IF,de Wit R,Berry WR,et al.Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer[J].N Engl J Med,2004,351(15):1502-1512.
[3]FAN LC,DONG BJ,XUE W,et al.Efficacy and prognostic factors of abiraterone combined with prednisone treating metastatic castration-resistant prostate cancer patients[J].Journal of Shanghai Jiaotong University (Medical Science),2017,37(11):1483-1488.[樊连城,董柏君,薛蔚,等.阿比特龙联合泼尼松治疗转移性去势抵抗性前列腺癌的疗效及预后因素分析[J].上海交通大学学报(医学版),2017,37(11):1483-1488.]
[4]Beer TM,Armstrong AJ,Rathkopf DE,et al.Enzalutamide in metastatic prostate cancer before chemotherapy[J].N Engl J Med,2014,371(5):424-433.
[5]De Bono JS,Oudard S,Ozguroglu M,et al.Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment:a randomised open-label trial[J].Lancet,2010,376(9747):1147-1154.
[6]Petrylak DP,Tangen CM,Hussain MH,et al.Docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer[J].N Engl J Med,2004,351(15):1513-1520.
[7]WANG NF,CHENG ZD.Application status and progression of thalidomide in treatment of solid tumors[J].Chin Clin Oncol,2015,20(3):276-281.[王年飞,陈振东.沙利度胺治疗实体瘤的现状与进展[J].临床肿瘤学杂志,2015,20(3):276-281.]
[8]Perez-Lopez R,Lorente D,Blackledge MD,et al. Volume of bone metastasis assessed with whole-body diffusion-weighted imaging is associated with overall survival in metastatic castration-resistant prostate cancer[J].Radiology,2016,280(1):151-160.
[9]Berthold DR,Pond GR,Soban F,et al.Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer:updated survival in the TAX 327 study[J].J Clin Oncol,2008,26(2):242-245.
[10]YE DW,ZHANG HL,YAO XD,et al.Docetaxel plus prednisone versus mitoxantrone plus prednisone for metastatic hormone-refractory prostate cancer in Chinese patients:experience of a single center[J].China Oncology,2007,17(3):236-239.[叶定伟,张海梁,姚旭东,等.多西他赛联合泼尼松或米托蒽醌联合泼尼松治疗激素抵抗性前列腺癌[J].中国癌症杂志,2007,17(3):236-239.]
[11]LUAN BH,LI XM,WU HX.Clinical effects of mitoxantrone plus prednisone in hormone refractory prostate cancer[J].The Practical Journal of Cancer,2014,29(10):1282-1284.[栾宝红,李晓梅,邬红霞.米托蒽醌联合泼尼松治疗激素抵抗性前列腺癌的临床效果[J].实用癌症杂志,2014,29(10):1282-1284.]
[12]YANG JG,CHEN JZ,ZHENG J,et al.Research progress on application of thalidom- ide on advanced solid tumors[J].Modern Oncology,2017,25(11):1805-1809.[杨建刚,陈继正,郑瑾,等.沙利度胺在治疗晚期实体肿瘤中的应用及研究进展[J].现代肿瘤医学,2017,25(11):1805-1809.]
[13]ZUO CY.Clinical observation of thalidomide combined with EP chemotherapy in the treatment of extensive small cell lung cancer [J].Journal of Basic and Clinical Oncology,2018,31(4):329-331.[左彩莹.沙利度胺联合 EP 化疗方案治疗广泛期小细胞肺癌临床观察[J].肿瘤基础与临床,2018,31(4):329-331.]
[14]ZHOU Y,ZHOU J,ZHONG SJ.Efficacy of thalidomide combined with FOLFOX4 for advanced hepatocellular carcinoma[J].The Practical Journal of Cancer,2017,32(1):115-117.[周毅,周健,钟盛洁.沙利度胺联合FOLFOX4方案治疗晚期原发性肝癌的疗效分析[J].实用癌症杂志,2017,32(1):115-117.]
[15]GE YN,HAN T,ZHENG ZD,et al.Maintenance treatment of S-1 combined thalidomide in elderly patients with advanced gastric cancer[J].Clin J Med Offic,2017,45(1):30-37.[葛亚楠,韩 涛,郑振东,等.替吉奥联合沙利度胺治疗老年晚期胃癌临床分析[J].临床军医杂志,2017,45(1):30-37.]
[16]MA SC,QIAO H,ZHAO D,et al.Effect of GP combination with thalidomide in treatment for advanced breast cancer[J].J Chin Oncol,2016,22(6):518-520.[马守成,乔慧,赵达,等.沙利度胺联合 GP 方案治疗晚期乳腺癌的疗效分析[J].肿瘤学杂志,2016,22(6):518-520.]
[17]LI HJ,Jin ZY.Clinical efficacy and adverse reactions analysis of thalidomide combined with GP regimen in the treatment of advanced triple-negative breast cancer[J].China Prac Med,2018,13(32):95-96.[李红姬,金载勇.沙利度胺联合GP方案治疗晚期三阴性乳腺癌的临床疗效及不良反应分析[J].中国实用医药,2018,13(32):95-96.]
[18]ZUO LJ,LIU WL,YIHEBALI C,et al.Clinical efficacy of etoposide capsule combined with thalidomide for resistant or chemotherapy intolerant advanced soft tissue sarcoma[J].Chin J Clin Oncol Rehabil,2018,15(12):1427-1430.[左立杰,刘维丽,依荷芭丽·迟,等.依托泊苷胶囊联合沙利度胺治疗耐药或无法耐受化疗的晚期软组织肉瘤患者的临床疗效[J].中国肿瘤临床与康复,2018,15(12):1427-1430.]
[19]SHI ZS,XU SS,LIU YR,et al.The clinical efficacy of metronomic chemotherapy with capecitabine and thalidomide in the treatment of advanced colorectal cancer and its influence on quality of life[J].Modern Oncology,2017,25(13):2089-2091.[施朕善,徐珊珊,刘友如,等.卡培他滨联合沙利度胺节拍化疗治疗晚期结直肠癌的疗效观察及其对生活质量的影响[J].现代肿瘤医学,2017,25(13):2089-2091.]
[20]ZHANG LL,CHEN P,XIE XP,et al.Clinical trial of improvement of advanced malignant tumor cachexia by thalidomide[J].China Licensed Pharmacist,2016,13(12):3-6.[张莉莉,陈萍,谢勋鹏,等.沙利度胺改善晚期恶性肿瘤恶液质的临床观察[J].中国职业药师,2016,13(12):3-6.]
[21]SUN ZL.Effect of megestrol acetate combined with thalidomide on improving advanced cancer cachexia[J].The Practical Journal of Cancer,2018,33(2):321-327.[孙兆楼.醋酸甲地孕酮联合沙利度胺治疗晚期癌症恶液质的效果[J].实用癌症杂志,2018,33(2):321-327.]
[22]FENG J,LIAO SG,ZHOU JP,et al.Clinical outcome of castrate-resistant prostate cancer patients with bone metastasis treated with thalidomide combined with docetaxel[J].China Oncology,2017,27(4):287-292.[冯静,廖绍光,周进平,等.沙利度胺联合化疗治疗骨转移去势抵抗性前列腺癌的疗效观察[J].中国癌症杂志,2017,27(4):287-292.]
[23]LIN JD,LUO HC,FU ZC,et al.Efficacy of thalidomide combined with docetaxel in patients with castrate-resistant prostate cancer[J].Lab Med Clin,2018,15(17):2543-2546.[林金德,骆华春,傅志超,等.沙利度胺联合多西他赛治疗去势抵抗性前列腺癌的临床研究[J].检验医学与临床,2018,15(17):2543-2546.]

备注/Memo

备注/Memo:
National Natural Science Foundation of China(No.81602567);国家自然科学基金项目(编号:81602567)
更新日期/Last Update: 1900-01-01