| 初诊伴有脊柱转移的前列腺癌生存相关因素分析 |
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| 引用本文： | 单露玲,韩秀鑫,张超,任志午,梁守磊,王国文.初诊伴有脊柱转移的前列腺癌生存相关因素分析[J].中国肿瘤临床,2015,42(17):862-865. |
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| 作者姓名： | 单露玲 韩秀鑫 张超 任志午 梁守磊 王国文 |
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| 作者单位： | 作者单位:天津医科大学肿瘤医院骨与软组织肿瘤科,国家肿瘤临床医学研究中心,天津市肿瘤防治重点实验室(天津市 300060) |
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| 摘 要： | 目的:探讨初诊时伴有脊柱转移的前列腺癌患者与生存相关的因素。方法:收集2005年1 月至2010年12月天津医科大学肿瘤医院接受内分泌治疗的前列腺癌脊柱转移患者49例，针对患者的碱性磷酸酶（ALP）、治疗前有无骨相关事件（SREs）、Gleason评分、治疗后PSA 最低值、激素敏感持续时间、有无化疗行单因素分析，并对存在统计学意义者进行多因素分析。结果:平均随访时间64.1 个月，死亡41例，中位生存时间为27个月，1 、3 、5 年生存率分别是81.6% 、40.8% 、20.4% 。单因素分析结果显示，有无联合化疗、ALP 水平、治疗前是否出现SRE 、Gleason评分、治疗后PSA 最低值及激素敏感持续时间与总生存率（OS）有关（P < 0.05）。 Cox 回归模型多因素分析显示，激素敏感持续时间≥ 19个月及联合化疗是较长生存时间的独立预后因素（P < 0.05）。结论:激素敏感持续时间及进展为去势抵抗性前列腺癌（castration resistant prostate cancer ，CRPC）后是否联合化疗是前列腺癌脊柱转移患者的预后独立因素。
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| 关 键 词： | 前列腺癌 脊柱转移 化疗 内分泌治疗 预后因素 |
| 收稿时间： | 2015-05-07 |
Analysis of prognostic factors associated with survival in men with prostate cancer accompanied by spinal metastases at first diagnosis |
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| Affiliation: | Department of Bone and Soft Tissue Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin300060, China |
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| Abstract: | Objective:Prostate cancer frequently metastasizes to the spine. In this study, we investigate the prognostic factors as -sociated with survival in patients with prostate cancer accompanied by spinal metastases at their preliminary diagnosis. Methods:Clin -ical data of 49patients who were diagnosed with spinal metastasis from prostate cancer between January 2005and December 2010 were analyzed. Variables including alkaline phosphatase (ALP), previous skeletal-related event, Gleason score, prostate-specific anti-gen (PSA) nadir, and time to castration resistance were obtained. Moreover, the relationship between these variables and overall sur-vival (OS) was analyzed. Survival analysis was performed by using Kaplan-Meier curves. Furthermore, the differences among the OS rates were assessed by using the log rank test. The variables were statistically significant in the univariate analysis ( P<0.05) and were included in the multivariate model. Results: The average follow-up time was 64.1 months among the 49patients. By the end of the follow-up, 41of these patients were dead; the mean survival was 27months. The1-, 3-, and 5-year survival rate was 81.6%,40.8%, and 20.4%, respectively. Univariate analysis identified that 6 variables were statistically significant prognostic factors of OS: with or without chemotherapy, ALP, previous skeletal-related event, Gleason score, PSA nadir, and time to castration resistance. The multivari-ate analysis showed that the time to castration resistance of ≥ 19months and the addition of chemotherapy after disease progression are independent prognostic factors for a high OS. Conclusion:With or without chemotherapy and the time to castration resistance are the independent prognostic factors associated with survival in patients with prostate cancer accompanied by spinal metastases at first diagnosis. |
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