演題抄録

臓器別シンポジウム

開催概要
開催回
第58回・2020年・京都
 

前立腺癌骨転移の多施設前向き観察研究の結果に基づくmHSPCの治療戦略

演題番号 : SY8-4

[筆頭演者]
溝上 敦:1 
[共同演者]
中嶋 憲一:2

1:金沢大学・医薬保健学域医学類・泌尿器科、2:金沢大学・核医学科

 

Recently, the use of BONENAVI in bone scintigraphy has made it possible to examine changes in bone metastases over time and quantitatively. In the present study, we conducted a multicenter prospective observational study from 2012 to 2017 to evaluate the usefulness of BONENAVI and the status of bone metastases in Japanese (PROSTAT-BSI). The results provided insights that can inform future treatment strategies for mHSPC. Hormone therapy-naive patients with bone metastases from 36 centers nationwide were enrolled in the and 148 analyzable patients were evaluated over a 3-year observation period. Patients were divided into three quartiles according to initial BSI (low: <0.9, intermediate: 0.9-3.5, high: >3.5). Gleason score (GS), presence or absence of visceral metastases, and the relationship between PSA-PFS, BSI-PFS and OS was assessed. Median PSA in mHSPC was 261 ng/mL. in mHSPC, GS affected OS, but visceral metastasis (lung metastasis 20 patients, 1 liver metastasis) had no effect on OS. Higher initial BSI was associated with worse PSA-PFS (p<0.0001) and BSI-PFS (p<0. 001), but there was no significant difference in the OS of the low and intermediate BSI groups and only the high BSI group had a poor OS (p<0.016). The results suggest that bone metastases up to intermediate BSI may be improved by post-relapse treatment in clinical practice. Comparing these results with clinical trials of strong combination therapy, the upfront clinical trials are quite different from actual clinical practice and need to be clinically validated in Japan.

キーワード

臓器別:前立腺・男性生殖器

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