| 刘 琛,吴小芬,丁家锋,等.药物洗脱珠经前列腺动脉化疗栓塞治疗去势抵抗性前列腺癌疗效分析[J].肿瘤学杂志,2024,30(10):853-858. |
| 药物洗脱珠经前列腺动脉化疗栓塞治疗去势抵抗性前列腺癌疗效分析 |
| Efficacy of Drug-Eluting Bead Prostatic Artery Chemoembolization in the Treatment of Castration-Resistant Prostate Cancer |
| 投稿时间：2024-07-18 |
| DOI：10.11735/j.issn.1671-170X.2024.10.B009 |
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| 中文关键词: 前列腺肿瘤 去势抵抗 前列腺动脉化疗栓塞 多西他赛 博来霉素 客观缓解率 前列腺特异性抗原 睾酮 |
| 英文关键词:prostate neoplasms castration-resistant prostatic artery chemoembolization docetaxel bleomycin objective response rate prostate specific antigen testosterone |
| 基金项目:浙江省丽水市本级公益性技术应用研究自筹项目（2020SJZC054） |
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| 中文摘要: |
| 摘 要：［目的］分析多西他赛联合博来霉素药物洗脱珠经前列腺动脉化疗栓塞（drug-eluting bead prostatic artery chemoembolization，DEB-PAC）治疗去势抵抗性前列腺癌（castration-resistant prostate cancer，CRPC）的效果。［方法］ 采用前瞻性随机对照方法，于2020年6月至2023年4月，对丽水市中心医院泌尿外科符合入组条件的CRPC患者随机分为试验组（负载多西他赛和博来霉素的药物微球超选择性前列腺动脉化疗栓塞）及对照组（全身标准多西他赛化疗方案）。治疗后对患者进行为期半年的随访观察，观察指标包括前列腺MRI扫描观察肿瘤病灶变化并计算客观缓解率，治疗前后前列腺特异性抗原（prostate specific antigen，PSA）及血清睾酮水平，新发全身骨转移数目、美国东部肿瘤协作组（Eastern Cooperative Oncology Group，ECOG）评分，以及不良反应发生情况。［结果］ 共64例患者入组，其中试验组33例，对照组31例。患者治疗后，客观缓解率试验组高于对照组（81.81% vs 54.84%，P=0.03）；PSA、睾酮水平试验组低于对照组（40.10±4.60 vs 60.54±5.45，P<0.01；17.07±2.93 vs 22.72±4.12，P<0.01）；相比对照组，试验组ECOG评分更低（P<0.05），新发转移灶更少（P<0.01）；不良反应发生率试验组低于对照组（P<0.05）。［结论］ CRPC患者接受DEB-PAC技术治疗可以获得较好的近期临床疗效，同时减少了化疗相关不良反应的发生。 |
| 英文摘要: |
| Abstract：［Objective］ To analyze the efficacy of drug-eluting bead prostatic artery chemoembolization (DEB-PAC) using a combination of docetaxel and bleomycin for the treatment of castration-resistant prostate cancer (CRPC). ［Methods］ From June 2020 to April 2023， CRPC patients eligible for admission in the Department of Urology， Lishui Central Hospital were randomly divided into experimental group (microsphere superselective prostate arterial chemoembolization loaded with docetaxel and bleomycin) and control group (standard systemic docetaxel chemotherapy) by a prospective randomized control method. The patients were followed up for half a year after treatment， including prostate MRI scanning to observe the changes of tumor lesions and calculate the objective response rate， as well as prostate specific antigen (PSA) and serum testosterone levels before and after treatment， the number of new systemic bone metastases， the Eastern Cooperative Oncology Group (ECOG) score， and the incidence of adverse reactions. ［Results］ A total of 64 patients were enrolled， including 33 patients in the experimental group and 31 patients in the control group. After treatment， the objective response rate of experimental group was higher than that of control group (81.81% vs 54.84%， P=0.03)； the levels of PSA and testosterone in experimental group were lower than those in control group (40.10±4.60 vs 60.54±5.45， P<0.01； 17.07±2.93 vs 22.72±4.12， P<0.01)； compared with the control group， the experimental group had lower ECOG score (P<0.05) and fewer new metastases(P<0.01)； the incidence of adverse reactions in experimental group was lower than that in control group (P<0.05). ［Conclusion］ Patients with CRPC treated with DEB-PAC technology could obtain better short-term clinical efficacy and reduce the occurrence of chemotherapy-related adverse reactions. |
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