肿瘤预防与治疗2025，Vol.38Issue(5)：369-376,8.DOI:10.3969/j.issn.1674-0904.2025.05.003
新型内分泌治疗加持下的寡转移激素敏感性前列腺癌患者的临床疗效分析
Clinical Efficacy of Novel Endocrine Therapy in Patients with Oligometa-static Hormone-Sensitive Prostate Cancer
摘要
Abstract
Objective:To evaluate the clinical efficacy of the novel combined androgen blockade(CAB)in patients with oligometastatic hormone-sensitive prostate cancer(OmHSPC).Methods:A retrospective analysis was conducted on the clinical data of 19 OmHSPC patients in Sichuan Cancer Hospital.All patients received the novel CAB regimen consisting of apalutamide plus androgen deprivation therapy(ADT),which included gonadotropin-releasing hormone(GnRH)antagonists(degarelix)and GnRH agonists(goserelin).Some patients were concurrently treated by local radiotherapy of the prostate.The outcome measures included changes in serum total prostate-specific antigen(tPSA),pain intensity,radiographic chan-ges,adverse events,biochemical progression-free survival(bPFS),and overall survival(OS).Univariable Cox proportional hazards regression analysis was employed to identify factors influencing overall survival(OS)in OmHSPC patients.Survival analysis was conducted using the Kaplan-Meier method.Additionally,linear regression analysis was conducted to determine factors affecting the duration of prostate-specific antigen(PSA)stability in these patients.Results:In our study,all patients were diagnosed with stage Ⅳ disease,radiologically confirmed metastases involving skeletal and pelvic lymph node basins,and completed follow-up.Among the 19 patients,16(84.2％)demonstrated stable tPSA levels without progression,while 3 patients(15.8％)developed castration-resistant prostate cancer(CRPC).Unfortunately,1 patient(5.3％)died.The me-dian bPFS was 22(7～29)months,with an average OS of(23.15±3.92)months and a median OS of 22(17～29)months.Overall,the disease control and survival outcomes were favorable.Univariable analysis revealed no statistically sig-nificant associations between OS and age,number of metastatic lesions,metastatic sites,or Gleason score(all P>0.05).Linear regression analysis revealed that time to PSA nadir was a significant predictor of the duration of PSA stabilization.Ad-verse events were observed in 8 patients(42.1％),including rash,fatigue,and oral ulcers,but all were grade 3 or lower.Rash was the most common adverse reaction(6/19,31.6％).No adverse reactions above grade 3 were reported for any of the patients.Conclusion:The novel CAB consisting of apalutamide and ADT demonstrates good clinical efficacy and survival benefits for patients with OmHSPC,along with favorable safety profiles.This systemic therapeutic strategy warrants further clinical attention.关键词
阿帕他胺/联合雄激素阻断/寡转移性前列腺癌/疗效Key words
Apalutamide/Combined androgen blockade/Oligometastatic prostate cancer/Curative efficacy分类
医药卫生引用本文复制引用
韩兴月,廖洪,周傲琦,李曾,刘金鹏,周术奎,吴毅,肖英明,杨盛柯,钟磊..新型内分泌治疗加持下的寡转移激素敏感性前列腺癌患者的临床疗效分析[J].肿瘤预防与治疗,2025,38(5):369-376,8.基金项目
四川省科技厅重点研发计划(编号:2020YFS0421) （编号:2020YFS0421）
四川省卫生健康委员会医学科技项目(编号:2023LCYJ004) This study was supported by grants from Science and Technology Department of Sichuan Province(No.2020YFS0421)and Health Commission of Sichuan Province(No.2023LCYJ004). （编号:2023LCYJ004）
