Development of nomogram to non-steroidal antiandrogen sequential alternation in prostate cancer for predictive model.
Development of nomogram to non-steroidal antiandrogen sequential alternation in prostate cancer for predictive model.
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开发前列腺癌非甾体抗雄激素顺序交替列线图的预测模型。
DOI：
10.1093/jjco/hyt230
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Miki T.
中科院分区：
文献类型：
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作者：
Kamiya N;Suzuki H;Nishimura K;Fujii M;Okegawa T;Matsuda T;Morita T;Takihana Y;Ozono S;Namiki M;Matsubara A;Ichikawa T;Miki T.
目的：阐明非甾体类抗雄激素替代治疗后前列腺特异性抗原下降≥50%的临床预测因素，并建立列线图预测非甾体类抗雄激素替代治疗后复发的晚期前列腺癌患者前列腺特异性抗原下降≥50%。我们以前曾报道，雄激素阻断与替代非甾体抗雄激素是有效的晚期前列腺癌复发后，最初的联合雄激素block.MethodsWe招募了161例患者从14个医疗机构组织学确诊的前列腺癌谁曾接受联合治疗，并在一线联合雄激素阻断治疗后癌症进展。一个列线图的前列腺特异性抗原减少≥50%，从基线前列腺特异性抗原的替代非甾体类抗雄激素治疗的基础上开发的最终Logistic回归model.ResultsOverall前列腺特异性抗原减少≥50%，在75 161例（46.6%）的替代非甾体类抗雄激素治疗。使用5个独立风险因素（前列腺特异性抗原的初始血清水平、血红蛋白、C反应蛋白、第二次激素治疗前前列腺特异性抗原最低值和Gleason总和），开发了一个列线图，用于预测替代非甾体抗雄激素治疗后前列腺特异性抗原降低≥50%。受试者工作特征曲线表明，该模型预测概率的准确性为72.5%.ConclusionsThis预测诺模图可以预测前列腺特异性抗原下降≥50%的响应替代非甾体抗雄激素治疗，可能是有益的，以确定序贯治疗策略后复发的患者首次联合雄激素阻断。
ObjectivesTo clarify clinical predictors for a prostate-specific antigen decrease≥50% in response to alternative non-steroidal antiandrogen therapy and to develop a nomogram to predict the prostate-specific antigen decrease≥50% in response to alternative non-steroidal antiandrogen therapy in patients with advanced prostate cancer that relapsed after initial combined androgen blockade. We previously reported that combined androgen blockade with an alternative non-steroidal antiandrogen is effective for advanced prostate cancer that has relapsed after initial combined androgen blockade.MethodsWe enrolled 161 patients from 14 medical institutions with histologically confirmed prostate cancer who had been treated with combination therapy and in whom cancer progressed after first-line combined androgen blockade therapy. A nomogram for the prostate-specific antigen decrease≥50% from baseline prostate-specific antigen in response to alternative non-steroidal antiandrogen therapy was developed based on the final logistic regression model.ResultsOverall prostate-specific antigen decreased≥50% in 75 of 161 patients (46.6%) in response to alternative non-steroidal antiandrogen therapy. Using five independent risk factors (initial serum level of prostate-specific antigen, hemoglobin, C-reactive protein, prostate-specific antigen nadir to second hormone therapy and Gleason sum), a nomogram was developed for the prediction of prostate-specific antigen decrease≥50% in response to alternative non-steroidal antiandrogen therapy. The receiver operating characteristic curve showed that the accuracy of the predicted probability was 72.5% for the model.ConclusionsThis predictive nomogram could predict the prostate-specific antigen decrease≥50% in response to alternative non-steroidal antiandrogen therapy and might be of benefit to determine the sequential treatment strategy in patients with relapse after first combined androgen blockade.