Is prednisolone as good as flutamide in hormone refractory metastatic carcinoma of the prostate?
Is prednisolone as good as flutamide in hormone refractory metastatic carcinoma of the prostate?
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DOI：
10.1097/00005392-199707000-00056
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发表时间：
1997-07-01
影响因子：
6.6
通讯作者：
Matthews, PN
中科院分区：
文献类型：
--
作者：
Datta, SN;Thomas, K;Matthews, PN
目的：前列腺癌二线治疗没有普遍接受的规则，很少有前瞻性研究试图比较两种不同作用方式的治疗策略。材料和方法：我们描述了一项前瞻性随机研究，对 40 名患者进行了比较，已知激素难治性 M1 期前列腺癌患者中氟他胺与泼尼松龙的二线反应。结果：接受任一治疗的患者的中位生存期为 32.9 周，两组之间没有差异。就生物反应而言，接受泼尼松龙治疗的 20 名患者中有 11 名 (55%) 和接受氟他胺治疗的 20 名患者中有 10 名 (50%) 表现出前列腺特异性抗原 (PSA) 抑制。接受泼尼松龙和氟他胺治疗的患者的平均最低 PSA 分别为初始 PSA 的 54% 和 52%。两个治疗组之间的长期生存率没有差异，尽管所有患者中有 35% 的患者生存超过 1 年，3 名患者的生存超过 2 年。结论：服用泼尼松龙的患者越多，疼痛缓解效果越好，尽管两种药物的耐受性良好，并且在体能状态或镇痛需求方面没有差异。
Purpose: There are no generally accepted rules for the second line treatment of prostate cancer and few prospective studies have attempted to compare 2 therapeutic strategies with different modes of action.Materials and Methods: We describe a prospective, randomized study of 40 patients comparing the second line response of flutamide to prednisolone in patients with known hormone refractory stage M1 prostate cancer.Results: The median survival of patients receiving either treatment was 32.9 weeks, with no difference between the 2 groups. In terms of biological response 11 of 20 patients (55%) receiving prednisolone and 10 of 20 (50%) receiving flutamide exhibited prostate specific antigen (PSA) suppression. Average minimum PSA was 54 and 52% of the initial PSA in patients receiving prednisolone and flutamide, respectively. There was no difference between the 2 treatment groups in terms of long-term survival, although 35% of all patients survived beyond 1 year and 3 survived beyond 2 years.Conclusions: More patients taking prednisolone described better pain relief, although both medications were well tolerated and there was no difference in terms of performance status or analgesic requirements.