阿比特龙联合泼尼松治疗去势抗拒前列腺癌的临床观察

目的 探讨新型雄激素合成抑制剂醋酸阿比特龙（Abriaterone acetate）治疗去势抗拒前列腺癌（castration-resistant prostate cancer，CRPC）的疗效及安全性。方法 经病理证实并符合入选标准的58例去势抗拒前列腺癌患者，中位年龄68岁（61~81岁），接受醋酸阿比特龙治疗，化疗至少2周期后。按实体瘤疗效评价标准（RECIST）美国NCI制定的毒性评价指标（CTC-AE3.0）评价疗效和毒性反应；采用Kaplan-meier法对患者总生存时间（OS）进行分析。结果 5例未完成总评估过程。可评价疗效的53例患者中，总有效率（ORR）18.87%（10例），疾病控制率（DCR）62.26%（33例）；中位OS为（15.0±1.2）月； 28例前列腺特异性抗原（prostate-specific antigen，PSA）下降﹥50%，治疗前后PSA中位数分别为78 ng/ml（18~1 776 ng/ml）和37 ng/ml（9~320 ng/ml），两者比较差异有统计学意义（P﹤0.05） ；化疗不良反应多为Ⅰ~Ⅱ级。结论 阿比特龙联合泼尼松治疗去势抗拒前列腺癌疗效较好，不良反应轻。

Clinical Observation of Abriaterone Acetate and Prednison on Patients with Castrationresistant Prostate Cancer

Objective To evaluate the efficacy and safety of Abriaterone acetate on the patients with castration-resistant prostate cancer(CRPC). Methods A total of 58 CRPC patients (median age: 68 years old) received two cycles of Abriaterone acetate. RECIST was used to assess the efficacy of the treatment and NCICTC-AE version 3.0 was used to describe adverse events; Kaplan-meier analysis was used for analyzing overall survival(OS). Results Five cases were not subjected to evaluate. Among 53 patients with castrationresistant prostate cancer, ORR was 18.87% (10 cases) and disease contral rate (DCR) was 62.26%(33 cases); The median OS was (15.0±1.2) month; The PSA levels were decreased in 53 patients, and decreased more than 50% in 28 patients. The median PSA level was 78 ng/ml (18~1 776 ng/ml) and 37 ng/ml (9~320 ng/ml) respectively before and after treatment, with significant difference(P﹤0.05). The principal drug related adverse events were grade Ⅰ - Ⅱ. Conclusion With minor toxicity, the combination of Abriaterone acetate plus prednisone has a certain effect on castration-resistant prostate cancer patients.