去势抵抗性前列腺癌个体化药物治疗的研究

Abstract

目的：探讨个体化化疗药物治疗去势抵抗性前列腺癌(Castration resistant prostate cancer, CRPC)的临床效果。方法将2013年2月至2014年12月山西医科大学第一医院泌尿外科收治的41例CRPC患者随机分为2组。治疗组检测TUBB3、ERCC1基因mRNA及MDR1基因多态性，根据结果针对性的选择化疗方案，个体化选用常见的三种化疗药物，包括多西他赛、米托蒽醌、顺铂；对照组单纯采用多西他赛治疗；两组患者从血清TPSA、肿瘤病灶变化、骨扫描、患者疼痛评分等指标进行比较，每3周为1个周期，连续治疗6个周期后进行评估。结果：1) 治疗后，治疗组血清TPSA值为30.9 ± 5.43，对照组血清TPSA值为39.1 ± 7.7，两组间疗效比较，差异有统计学意义(P < 0.05)；2) 治疗后，治疗组疼痛评分值为5.5 ± 0.94，对照组疼痛评分值为6.4 ± 1.27，两组间疗效比较，差异有统计学意义(P < 0.05)；3) 治疗后，治疗组骨扫描转移病灶明显减少，与对照组减少幅度相比，差异有统计学意义(P < 0.05)；4) 治疗后，治疗组肿瘤病灶明显缩小，与对照组缩小幅度相比，差异有统计学意义(P < 0.05)。结论个体化化疗对CRPC患者具有针对性强，疗效好，能使患者生存获益，具有临床推广价值。 Objective: To study the individualized chemotherapy drug castration resistant prostate cancer (CRPC) clinical effect. Methods: Prospective, randomized, controlled method, will in February 2013 to December 2014, Shanxi medical university first hospital uropoiesis surgical department of 41 patients with CRPC were randomly divided into 2 groups. Treatment group detection TUBB3, ERCC1 gene mRNA and MDR1 gene polymorphism, according to the results of the choice of targeted chemotherapy regimens, individualized selection of common three kinds of chemotherapy drugs, including his dorsey, mitoxantrone, cisplatin; More than the control group only with west he match treatment; Change from two groups patients serum TPSA, tumor lesions, bone scan, the patient pain score metrics such as comparison, every three weeks for a cycle, continuous assessment after treatment for 6 cycles. Results: 1) after treatment, the treatment group serum TPSA value was 30.9 ± 5.43, the control group, serum TPSA value was 39.1 ± 7.7 curative effect comparison between the two groups, the difference was statistically significant (P < 0.05); 2) after treatment, the treatment group pain score value of 5.5 ± 0.94, control pain score value of 6.4 ± 1.27, curative effect comparison between the two groups, the difference was statistically significant (P < 0.05); 3) after treatment, the treatment group metastatic lesions significantly reduced bone scan, decrease rate compared with control group, the difference was statistically significant (P < 0.05); 4) after treatment, the treatment group significantly reducing tumor lesions, compared with the control group shrank, the difference was statistically significant (P < 0.05). Conclusion: individualized chemotherapy for patients with CRPC targeted strong, good curative effect, can make the patients survival benefit, has clinical value.