调查高风险因素,准确诊断和治疗割抵抗性前列腺癌 (CRPC)
Yuan Ma1,2, Zihao Liu1,2, Wenyue Yu2
1Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China.
Combinatorial chemistry & high throughput screening
|November 22, 2023
概括
识别远程转移和特定的PSA/水平等高风险因素是晚期前列腺癌的关键. 精密治疗耐除前列腺癌 (CRPC) 显著改善了无进展的生存率.
科学领域:
- 在瘤学瘤学.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 癌症研究 癌症研究
背景情况:
- 转移性割抵抗性前列腺癌 (mCRPC) 提出了重大的临床挑战.
- 识别晚期前列腺癌进展的高风险因素对于及时干预至关重要.
- 延迟CRPC的发病是前列腺癌管理的首要目标.
研究的目的:
- 探索影响前列腺癌进展的高风险因素.
- 强调病因分类对于精确诊断和治疗CRPC的重要性.
- 在mCRPC中评估精密处理策略的有效性.
主要方法:
- 对277例前列腺癌 (PCa) 病例进行了回顾性分析,这些病例接受了内分泌治疗,并监测了PSA和水平.
- 对60名CRPC患者的前性分析,分为精密治疗 (n=30) 和常规治疗 (n=30) 组.
- 精确治疗包括第二次活检和针对性治疗的分子亚型.
主要成果:
- 远程转移,PSA最低点> 0.2 ng/mL,丸激素最低点> 20 ng/dL,丸激素最低点的时间> 6个月被确定为CRPC进展的显著风险因素.
- 精确治疗组的PSA无进展生存时间中位数显著较长 (16.0个月与13.0个月,P=0.025).
- 精密治疗组中,无无进展的中位数X射线生存时间也显著延长 (21.0个月对比16.0个月,P=0.042).
结论:
- 建议在初始诊断时对前列腺癌患者进行远程转移的早期干预.
- 在前列腺癌的内分泌治疗期间,密切监测PSA和丸激素是必不可少的.
- 以病因分类为指导的精密治疗改善了CRPC患者的治疗结果和预后.
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