在治疗前列腺癌的低剂量胸膜疗法后,服用α-1上腺抗剂的持续时间
Kenta Onishi1, Yasushi Nakai1, Fumisato Maesaka1
1Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, Japan.
Japanese journal of clinical oncology
|August 28, 2024
概括
大多数前列腺癌患者可以在低剂量率支臂治疗 (LDR-BT) 一年内停止α-1上腺激素抗剂. 老年患者或有尿道问题的人可能会出现长期症状,需要在LDR-BT后仔细监测.
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
- 辐射疗法 辐射疗法
背景情况:
- 尿路功能障碍是前列腺癌低剂量治疗 (LDR-BT) 后的常见不良事件.
- 阿尔法-1上腺激素抗剂经常用于管理这些尿路症状.
研究的目的:
- 调查前列腺癌患者在启动LDR-BT后使用α-1上腺抗剂的持续时间.
- 为了确定长期使用药物和随后恢复α-1上腺抗剂的预测因素.
主要方法:
- 对1663名前列腺癌患者的回顾性分析,这些患者在2004年至2022年期间接受LDR-BT治疗.
- 评估阿尔法-1上腺抗剂撤销的时间和影响它的因素.
- 对恢复药物治疗的风险因素的分析.
主要成果:
- 89.3%的患者停止了α-1上腺激素抗剂,其中66.8%在LDR-BT的一年内实现了这一目标.
- 年龄≥70岁,治疗前的下尿道症状 (LUTS),较高的国际前列腺症状得分 (IPSS),较高的过活性膀症状得分 (OABSS) 和较高的残留尿量与延长的戒断时间有关.
- 24.0%的患者需要恢复α-1上腺激素抗剂,通常是在LDR-BT后的1-3年之间,与尿路症状爆发相吻合.
- 额外的外部光束放射治疗和高预处理OABSS独立预测恢复.
结论:
- 在大多数前列腺癌患者中,LDR-BT允许在一年内撤销α-1上腺抗剂.
- 老年患者和已有LUTS患者可能会出现更持久的尿功能障碍.
- 治疗后1-3年可能出现尿症状的爆发,需要密切监测,特别是在接受补充放射治疗或高OABSS的患者中.
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