荷爾蒙療法失敗之轉移性前列腺癌使用二線荷爾蒙藥物治療之單一醫院經驗
莊毓峰、黃立華、許兆畬、黃鐘銘、翁瑋駿、李毅彥
林益聖、謝肇新、陳祥來、戴浩平、童敏哲、歐宴泉
童綜合醫院外科部泌尿科
Management of mCRPC with second-line hormone therapies: A single-hospital experience
Yu-Feng Chuang, Li-Hua Huang, Chao-Yu Hsu, Zhon-Min Huang, Wei-Chun Weng, I-Yen Lee
Yi-Sheng Lin, Siu-San Tse, Hsiang-Lai Chen, Hao-Ping Tai, Min-Che Tung, Yen-Chuan Ou
Tungs' Metro Harbor Hospital · Section of Urology, Department of Surgery
Purpose: We investigate Metastatic Castration-resistant Prostate Cancer (mCRPC) patients with second-line hormone therapies as Abiraterone and Enzalutamide in single-hospital.
Materials and Methods: A total 52 mCRPC patients with 30 of these patients status post second-line chemotherapy as Docetaxel. The cases recorded from August 18, 2016 to Feburary 26, 2018. We managed these patients with second-line hormone therapies as Abiraterone and Enzalutamide. With study separate to four group as Abiraterone(12 patients), Abiraterone status post Docetaxel(16 patients), Enzalutamide (10 patients), and Enzalutamide status post Docetaxel(14 patients).
Results: There Spearman correlation showed PSA decrease value v.s. PSA decrease to half value (0.51, P<0.001) and Initial value v.s. PSA decrease value (0.96, P<0.0001) in all paitents. But there are no statistically significant differences of PSA reduce value in the four groups. The PSA reduce to half rate and average days in four group showed: 58.33% in 41.7d, 37.5% in 129.3d, 50% in 39.2d, 71.43% in 72.8d. The PSA lowest point date after second-line hormone therapies as 161.8d, 132.8d, 61.7d, 120.8d.
Conclusions: The PSA decrease to half value and initial PSA level are predictable index to overall PSA decrease value in all mCRPC patients. The average days of PSA reduce to half time in non-Docetaxel group around 6 weeks (41.7d, 39.2d) with status post Docetaxel group much longer (129.3d, 72.8d). There are no statistically significant differences of PSA reduce level in the four groups, but the Abiraterone shows slower response as lowest point PSA when compare with Enzalutamide (161.8d, 132.8d v.s. 61.7d, 120.8d).