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

背景与目的:多西他赛联合泼尼松治疗可延长转移性去势抵抗性前列腺癌患者的生存期,血管生成抑制剂也可抑制肿瘤生长,联合治疗的疗效目前仍不明确.该研究旨在观察沙利度胺联合多西他赛和泼尼松治疗骨转移的去势抵抗性前列腺癌的近期临床疗效.方法:收集2008年12月—2015年6月南京军区福州总医院收治的骨转移去势抵抗性前列腺癌患者78例,其中40例作为对照组给予多西他赛和泼尼松方案化疗,38例作为观察组在对照组的基础上给予沙利度胺联合化疗,观察两组有效率、骨痛缓解率、前列腺特异性抗原(prostate specific antigen,PSA)无进展时间、无疾病进展时间及总生存时间,并评价不良反应.结果:观察组有效率为65.79%,PSA无进展时间为4.13个月,无疾病进展时间为4.25个月,骨痛缓解率为86.84%;对照组有效率为40.00%,PSA无进展时间为3.54个月,无疾病进展时间为3.75个月,骨痛缓解率为60.00%,观察组均高于对照组,差异有统计学意义(P<0.05).治疗后两组总生存时间、患者恶心呕吐及白细胞下降等不良反应发生率比较,差异无统计学意义(P>0.05).结论:沙利度胺联合化疗治疗骨转移的去势抵抗性前列腺癌近期临床效果满意,安全,不增加不良反应,具有较高的临床应用价值.

Clinical outcome of castrate-resistant prostate cancer patients with bone metastasis treated with thalidomide combined with docetaxel

Background and purpose: Docetaxel plus prednisone chemotherapy can improve the patients' survival for castrate-resistant prostate cancer. Angiogenesis inhibitors can also inhibit the growth of tumor. The curative effect of combined treatment is still not clear. This study aimed to evaluate the efficacy of docetaxel plus prednisone combined with thalidomide in treating castrate-resistant prostate cancer (CRPC) patients with bone metastasis. Methods:A total number of 78 CRPC patients were selected in Fuzhou General Hospital from Dec. 2008 to Jun. 2015. Seventy-eight patients were divided into two groups: 40 patients in chemotherapy group (docetaxel plus prednisone) and 38 patients in combined treatment group (docetaxel plus prednisone combined with thalidomide). A total number of 78 subjects were evaluated by the effective rate, the remission rate of bone pain, the prostate specific antigen (PSA) progression-free surviv-al, the overall survival and adverse effect. Results: The response rate (65.79%) and the remission rate of bone pain (86.84%) in combined treatment group were both higher than those in chemotherapy group (40.00% and 60.00%, P<0.05). The PSA progression-free survival (4.13 months), progression-free survival (4.25 months) and the overall survival (18.06 months) in combined treatment group were all longer than those in chemotherapy group (3.54, 3.75 and 16.26 months). The PSA pro-gression-free survival was significantly longer in combined treatment group (P<0.05). There was no significant difference in the overall survival between two groups (P>0.05). The rates of adverse effects including peripheral neuritis and lethargy in combined treatment group (26.32% and 55.26%) were higher than those in chemotherapy group (5.00% and 17.50%, P<0.05). Conclusion: Thalidomide combined with docetaxel plus prednisone in CRPC patients with bone metastasis can prolong the PSA progression-free survival and overall survival. The adverse effects are mild. It may become a new choice of treatment for CRPC.