Relationship between serum testosterone level,clinical efficacy and prognosis of docetaxel treatment in castration-resistant prostate cancer
Objective To investigate the relationship between serum testosterone(T)level,therapeutic effect and prognosis of docetaxel treatment in castration-resistant prostate cancer(CRPC).Methods A total of 119 patients with CRPC treated with docetaxel in the 924th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from January 2017 to January 2019 were retrospectively collected,and they were divided into progression group(49 cases)and non-progression group(70 cases)according to disease progression during follow-up period.The differences of serum T levels among different pathological features between progression group and non-progression group were analyzed,the Kaplan-Meier survival curve was drawn to analyze different survival rate among different serum T levels,and the factors affecting the prognosis of CRPC patients were analyzed by univariate and multivariate COX regression analysis.Results With a median follow-up of 43(34-59)months,the serum T level in the progressive group was lower than that in the non-progressive group(t=-19.695,P＜0.05).The serum T level in patients with Gleason score 9-10 was lower than that in patients with Gleason score 8 and Gleason score 5-7(P＜0.05).The serum T level in patients with TNM stage Ⅲ C to Ⅳ B,visceral metastasis,bone metastasis,prostate-specific antigen(PSA)≥ 10 ng/mL was lower than that in patients with TNM stage Ⅲ A to Ⅲ B,no visceral metastasis,no bone metastasis and PSA＜10 ng/mL(P＜0.05).Overall survival rates in T＜1.15 nmol/L group was lower than that in T≥1.15 nmol/L group(Log-Rankx2=9.488,P＜0.01).Bone metastasis and T＜1.15 nmol/L were risk factors affecting the prognosis of CRPC patients(P＜0.01).Conclusions Low T level is associated with Gleason score,TNM high stage,visceral metastasis,bone metastasis,increased PSA level at baseline,disease progression after docetaxel treatment and poor prognosis of CRPC patients.
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