Kết quả điều trị bước 1 trên bệnh nhân ung thư tiền liệt tuyến giai đoạn IV bằng docetaxel kết hợp với liệu pháp ức chế androgen=Outcomes of first-line treatment with docetaxel combined with androgen deprivation therapy in patients with stage IV prostate cancer

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Tác giả: Thị Thu Hường Nguyễn, Ngọc Nam Phùng

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.142-151

Bộ sưu tập: Metadata

ID: 478132

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Đánh giá kết quả điều trị, tác dụng không mong muốn của phác đồ Docetaxel kết hợp với liệu pháp ức chế Androgen (ADT) trên bệnh nhân ung thư tuyến tiền liệt giai đoạn IV có yếu tố tiên lượng xấu. Đối tượng và phương pháp nghiên cứu: nghiên cứu mô tả hồi cứu trên bệnh nhân ung thư tuyến tiền liệt giai đoạn IV điều trị với Docetaxel và ADT tại bệnh viện Ung Bướu Hà Nội từ 01/2019 đến 9/2024. Kết quả: 40 bệnh nhân được lựa chọn vào nghiên cứu. Tuổi trung bình của đối tượng nghiên cứu là 66 tuổi và 36 (90%) bệnh nhân có chỉ số PS 0-1. Điểm gleason thường gặp là 8-10, ở 27/40 (67,5%) bệnh nhân. PSA trung bình trước điều trị là 314 ng/ml. Vị trí di căn thường gặp là xương 37/40 (92,5%) bệnh nhân, hạch 28/40 (70%). Về kết quả điều trị, có 34 (85%) bệnh nhân đạt đáp ứng 1 phần, 6 (15%) bệnh nhân bệnh giữ nguyên. Tỉ lệ đạt PSA ≤ 4 ng/ml trong khoảng thời gian ≤ 6 tháng là 70% (28 bệnh nhân). Tỉ lệ bệnh nhân đạt PSA <
0,2 ng/ml tại thời điểm 6 tháng và 12 tháng là 30% (12 bệnh nhân) và 37,5% (15 bệnh nhân). Thời gian trung bình đến tiến triển lâm sàng là 23,8 tháng. Thời gian đến kháng cắt tinh hoàn trung bình là 22,9 tháng. Tác dụng không mong muốn thường gặp là hạ bạch cầu trung tính, gặp ở 24 (60%) bệnh nhân, trong đó 6 (15%) bệnh nhân từ độ 3 trở lên. Kết luận: Docetaxel là phác đồ có hiệu quả tốt trong điều trị ung thư tuyến tiền liệt giai đoạn IV có yếu tố tiên lượng xấu với tác dụng không mong muốn chủ yếu là hạ bạch cầu.To evaluate treatment outcomes and side effects of Docetaxel combined with Androgen deprivation therapy (ADT) in patients with stage IV prostate cancer with poor prognostic factors. Materials and methods: Retrospective descriptive study was conducted on stage-IV prostate cancer patients treated with Docetaxel and ADT at Hanoi Oncology Hospital from January 2019 to September 2024. Results: 40 patients were enrolled. Their mean age was 66 years, and 36 (90%) patients had PS score of 0-1. Most patients (27 cases – 67.5%) had the Gleason score of 8-10s. The mean pre-treatment PSA was 314 ng/ml. The common metastatic sites were bone, observed in 37/40 (92.5%) patients and lymph nodes, in 28/40 (70%) patients. Regarding the treatment response, 34 (85%) patients achieved a partial response, and 6 (15%) patients had stable disease. The rate of achieving PSA ≤ 4 ng/ml within ≤ 6 months was 70% (28 patients). The rate of patients achieving PSA <
0.2 ng/ml at 6 months and 12 months was 30% (12 patients) and 37.5% (15 patients). The median time to progression was 23.8 months. The median time to castration resistance was 22.9 months. The most common side effect was neutropenia, occuring in 24 (60%) patients, 6 (15%) of them were at grade 3 or higher. Conclusion: Docetaxel is an effective regimen in the treatment of stage IV prostate cancer with poor prognostic factors, with the common side effect being leukopenia.

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