Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press45710.17650/1726-9776-2015-11-2-77-84PROSTATE CANCERРАК ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫPredictors of overall survival in patients with metastatic castration-resistant prostate cancerФакторы прогноза общей выживаемости больных метастатическим кастрационно-резистентным раком предстательной железыMarkovaA. S.МарковаА. С.
Russian Federation
mark-an1@ya.ruPolikarpovaS. B.ПоликарповаС. Б.
Russian Federation
KamolovB. Sh.КамоловБ. Ш.
Russian Federation
GridnevaYa. V.ГридневаЯ. В.
Russian Federation
KalininS. A.КалининС. А.
Russian Federation
PetersM. V.ПетерсМ. В.
Russian Federation
MatveevV. B.МатвеевВ. Б.
Russian Federation
Department of Oncology, Faculty of Therapeutics, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russiaкафедра онкологии лечебного факультета ГБОУ ВПО «Первый МГМУ им. И. М. Сеченова» Минздрава России2 Bldg. 8, Trubetskaya St., Moscow 119992, RussiaРоссия, 119992, Москва, ул. Трубецкая, 8, стр. 2Urology Department, N.N. Blokhin Russian Cancer Research CenterУрологическое отделение ФГБНУ «РОНЦ им. Н. Н. Блохина»23, Kashirskoe Shosse, Moscow 115478, RussiaРоссия, 1154787, Москва, Каширское шоссе, 23Department of Oncology and Radiotherapy, Faculty of Therapeutics, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russiaкафедра онкологии и лучевой терапии лечебного факультетата ГБОУ ВПО «РНИМУ им. Н. И. Пирогова» Минздрава России1, Ostrovityanov St., Moscow 117997, RussiaРоссия, 117997, Москва, ул. Островитянова, 1Department of Oncology, Russian Medical Academy of Postgraduate Education, Ministry of Health of Russiaкафедра онкологии ГБОУ ДПО «Российская медицинская академия последипломного образования» Минздрава России2/1, Barrikadnaya St., Moscow 125993, RussiaРоссия, 125993, Москва, ул. Баррикадная, 2/13006201511277841906201519062015https://oncourology.abvpress.ru/oncur/article/view/457

Objective: to estimate overall survival (OS) rates in patients with metastatic castration-resistant prostate cancer (mCRPC), who have received currently available drugs and to identify the predictors of OS.

Subjects and methods. The case histories of 112 patients with mCRPC treated at the N.N. Blokhin Russian Cancer Research Center in 2005 to 2014 were retrospectively analyzed. All the patients had received standard regimens based on docetaxel, cabazitaxel, abiraterone acetate in combination with prednisolone.

Results. Whatever the treatment option was, three-year OS rate was 32.0 ± 5.44 %; median survival was 24.3 months. The following poor prognostic factors for OS were pain syndrome; an ECOG performance status score of 2; the levels of prostate-specific antigen ≥ 288 ng/ml, lactate dehydrogenase ≥ 450 U/l, alkaline phosphatase ≥ 250 U/l, calcium < 2.28 mmol/l, and hemoglobin < 11.5 g/dl; as well as < 24 months’ duration of a response to hormonal therapy.

Conclusion. The use of standard drug treatment regimen for mCRPC may increase survival in this category of patients to achieve 3-years OV; and the identified factors of OV may aid in choosing treatment policy.

Введение. Развитие кастрационно-резистентного рака предстательной железы (КРРПЖ) традиционно ассоциировано с неблагоприятным прогнозом. Однако расширение возможностей лекарственного лечения КРРПЖ позволило увеличить продолжительностьжизни этой категории пациентов до 2–3 лет.

Цель работы – оценка общей выживаемости (ОВ) больных метастатическим КРРПЖ (мКРРПЖ), получавших лечение современными лекарственными препаратами, а также выявление факторов прогноза ОВ.

Материалы и методы. Проведен ретроспективный анализ историй болезни 112 больных мКРРПЖ, проходивших лечение в ФГБНУ «РОНЦ им. Н. Н. Блохина» в период с 2005 по 2014 г. Все пациенты получали стандартные схемы лечения на основе доцетаксела, кабазитаксела, абиратерона ацетата в комбинации с преднизолоном.

Результаты. Вне зависимости от вида лечения показатель 3-летней ОВ составил 32,0 ± 5,44 %, медиана выживаемости – 24,3 мес. Определены следующие факторы неблагоприятного прогноза ОВ: наличие болевого синдрома, статус по шкале ECOG 2, уровень простатспецифического антигена ≥ 288 нг/мл, лактатдегидрогеназы ≥ 450 Ед/л, щелочной фосфатазы ≥ 250 Ед/л, кальция < 2,28 ммоль/л и гемоглобина < 11,5 г/дл, а также длительность ответа на гормональную терапию < 24 мес.

Заключение. Использование современных схем лекарственного лечения мКРРПЖ позволяет увеличить продолжительность жизни пациентов этой категории, достигая 3-летней ОВ, а выявленные факторы прогноза ОВ могут помочь при выборе тактики лечения.

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