在转移性激素敏感前列腺癌中扩展与标准多塞尔:现实世界队列研究
Urologia internationalis
|January 19, 2026
概括
在转移性激素敏感前列腺癌 (mHSPC) 中,延长多塞塔塞尔超过六个周期并不能提高存活率. 在三重疗法无法获得的情况下,标准的六次多塞塔克塞尔疗程仍然有效.
科学领域:
- 在瘤学瘤学.
- 临床研究 临床研究
- 前列腺癌治疗方法 前列腺癌治疗方法
背景情况:
- 抗雄激素剥夺疗法 (ADT) 加上六个周期的多塞塔塞尔是转移性激素敏感前列腺癌 (mHSPC) 的标准第一线治疗方法.
- 三重疗法已经出现,但在许多地区,ADT加dcetaxel仍然是唯一可用的选择.
- 在mHSPC中延长多塞塔克塞尔超过六个周期的益处是不确定的.
研究的目的:
- 在新诊断的mHSPC患者中评估延长的多塞塔克塞尔治疗的疗效和安全性.
- 为了比较标准和扩展的多塞塔克塞尔疗法之间的无进展生存 (PFS1),随后治疗后进展的时间 (PFS2) 和整体生存 (OS).
- 评估延长使用多塞塔克塞尔的毒性概况.
主要方法:
- 从2014年到2022年,对98名mHSPC患者进行了回顾性队列研究,这些患者接受了ADT加多塞 (75 mg/m2) 治疗.
- 患者被分成两组:4-6个周期 (n=60) 和7-10个周期 (n=38).
- 使用卡普兰-梅尔和考克斯模型分析了生存结果和不良事件 (CTCAE v5.0).
主要成果:
- 在 4-6 周期组 (12.6 个月) 和 7-10 周期组 (12.2 个月) (HR 1.13; p=0.713) 之间,PFS1 的中位数相似.
- 总生存期 (OS) 也是可以比较的 (38.5个月与52.9个月;HR 0.99;p=0.958).
- 延长治疗导致整体毒性较高 (68.4%与38.3%相比;p=0.004),主要是外围神经病变和皮肤病事件,而严重事件 (等级≥3) 类似.
结论:
- 在一线mHSPC中延长多塞塔克塞尔超过六个周期并没有提供生存益处.
- 增加的毒性,包括外围神经病变和皮肤病变事件,与延长的多西治疗有关.
- 六个周期的多塞仍然是mHSPC的有效和务实的一线标准,当三重疗法不可用时.
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