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近年来,中国的前列腺癌发病率逐年上升。大多数前列腺癌患者在初诊时已处于中晚期,虽然内分泌治疗在一定时期内可以使病情得到控制与改善,但经过18~24个月的中位缓解期后,绝大多数患者均进展为预后极差的转移性去势抵抗性前列腺癌(metastatic castration-resistant prostate cancer,m CRPC)。mCRPC的治疗颇为棘手,迫切需要优化其治疗策略来提高疗效。目前已有研究表明,新型内分泌药物如醋酸阿比特龙、恩杂鲁胺与多西紫杉醇化疗可以使mCRPC患者生存获益,但有关治疗次序的选择仍存在一定争议。本文对mCRPC患者在化疗前后接受不同次序的新型内分泌药物治疗相关的临床研究进展进行综述,以期为正确选择mCRPC治疗策略提供依据,进而延长患者的总生存期并提高生活质量。
In recent years, the incidence of prostate cancer in China has increased year by year. Most of the patients with prostate cancer are in the advanced stage of the new diagnosis. Although the treatment of endocrine can be controlled and improved within a certain period of time, after the median of 18 to 24 months, the majority of patients progress to the prognosis Very poor metastatic castration-resistant prostate cancer (mCRPC). The treatment of mCRPC is rather tricky and there is an urgent need to optimize its treatment strategy to improve the efficacy. At present, studies have shown that the new endocrine drugs such as abiraterone acetate, enzalutamide and docetaxel chemotherapy can benefit the survival of mCRPC patients, but the order of treatment there is still some controversy. This review summarizes the clinical progress of mCRPC patients receiving different orders of new endocrine drugs before and after chemotherapy in order to provide the basis for the correct selection of mCRPC treatment strategies and to prolong the overall survival and quality of life of patients with mCRPC.