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目的分析陕西地区确诊为去势抵抗型前列腺癌(CRPC)患者行阿比特龙治疗的早期疗效及安全性,为后续治疗提供经验。方法纳入2015年12月至2016年9月陕西省西安市内五家大型三甲医院泌尿外科共计50例CRPC患者,选择使用阿比特龙联合强的松治疗,长期随访并记录治疗期间特异性前列腺抗原(PSA)、睾酮水来变化情况,每3个月复查全身骨显像、盆腔CT或MRI资料,观察并记录药物副作用,分析其中用药12周以上的30例有效病例的临床资料。结果按照PSA工作组(PSAWG)标准,30例患者PSA总体缓解率76%;按是否曾行多西他赛化疗分类,化疗失败后使用阿比特龙PSA缓解率为67%,未行化疗患者PSA缓解率达80%;按患者年龄分类,60~<70、70~80、>80岁PSA缓解率分别为85%、90%和61%;按患者PSA值分类,4~<10、10~80、>80ng/mL以上PSA缓解率分别为100%、66%和75%。阿比特龙总体耐受性良好,在我省以腹泻、水肿、低钾、肝损害常见,30例患者中3例患者出现轻度水肿,3例患者出现一过性肝功异常,1例患者出现罕见的横纹肌溶解和急性肾功损害,药物治疗后均恢复。结论陕西地区CRPC患者口服阿比特龙治疗早期疗效确切,安全性较高,可作为CRPC治疗的推荐方案之一。
Objective To analyze the early effect and safety of abiraterone treatment in patients with clinically proven castration-resistant prostate cancer (CRPC) in Shaanxi Province and provide experience for follow-up treatment. Methods A total of 50 patients with CRPC were enrolled in the urology department of five large-scale top-three hospitals in Xi’an from December 2015 to September 2016. The patients were treated with abiraterone plus prednisone. Long-term follow-up and recording of specific prostate antigens during treatment (PSA) and testosterone water. All cases were examined with bone imaging, pelvic CT or MRI data every 3 months. The side effects of the drugs were observed and recorded. The clinical data of 30 patients who were treated for more than 12 weeks were analyzed. Results According to PSA Working Group (PSAWG) criteria, the overall response rate of PSA in 30 patients was 76%. According to the chemotherapy class of docetaxel, the response rate of abiraterone PSA after failure of chemotherapy was 67% The remission rate was 80%. According to the patient’s age, the remission rates of PSA were 85%, 90% and 61% in 60 ~ 70, 70-80 and 80 years respectively. According to the classification of PSA, 80,> 80ng / mL PSA response rates were 100%, 66% and 75%. Abiraterone overall good tolerance in our province with diarrhea, edema, hypokalemia, liver damage common, 30 patients with mild edema in 3 patients, 3 patients had transient liver dysfunction, 1 patient A rare rhabdomyolysis and acute renal damage, drug treatment were restored. Conclusions The treatment of CRBP patients in Shaanxi province with early efficacy of oral abiraterone treatment is effective and safe and may be used as one of the recommended regimens for the treatment of CRPC.