Therapeutic efficacy of spleen-invigorating, dampness-removing and stasis-dissolving formula combined with endocrinotherapy for metastatic hormone-sensitive prostate cancer
10.3760/cma.j.cn115355-20231113-00185
- VernacularTitle:健脾利湿化瘀方联合内分泌治疗对转移性激素敏感性前列腺癌的治疗效果
- Author:
Shanqi GUO
1
;
Binxu SUN
;
Xingkang JIANG
;
Tong YANG
;
Yingjie JIA
;
Fanming KONG
Author Information
1. 天津中医药大学第一附属医院肿瘤科 国家中医针灸临床医学研究中心,天津 300381
- Keywords:
Prostatic neoplasms;
Neoplasm metastasis;
Prescriptions;
Endocrine system
- From:
Cancer Research and Clinic
2024;36(7):503-508
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the therapeutic efficacy of spleen-invigorating, dampness-removing and stasis-dissolving formula (SDSF) combined with endocrinotherapy for metastatic hormone-sensitive prostate cancer (mHSPC).Methods:A retrospective case control study was conducted. The clinical data of 193 mHSPC patients treated at First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, the Second Hospital of Tianjin Medical University, and Tianjin First Central Hospital from January 2018 to March 2021 were retrospectively analyzed. All patients were treated with continuous endocrinotherapy and they were divided into the combination therapy group (82 cases) and the monotherapy group (94 cases) based on whether they received SDSF treatment or not. Prostate specific antigen (PSA), serum testosterone, blood lipids (triglyceride, total cholesterol), fasting blood glucose, and international prostate symptoms score (I-PSS) and Karnofsky score were compared between the 2 groups. Kaplan-Meier method was used to analyze the progression-free survival (PFS), and log-rank test was performed. The Cox proportional risk model was used to make univariate analysis and multivariate analysis on the influencing factors of PFS.Results:A total of 176 mHSPC patients were finally enrolled and the age was 67±11 years. There were no statistically significant differences in terms of PSA, serum testosterone, triglyceride, total cholesterol and fasting blood glucose, I-PSS score and Karnofsky score between the two groups (all P > 0.05). A total of 91 mHSPC patients developed metastatic castration resistant prostate cancer (mCRPC), including the combination therapy group (40 cases) and the monotherapy group (51 cases), and 9 patients died because of the progression to mCRPC. The median PFS time of all patients was 19 months, that was 17.9 months in the monotherapy group and 20.4 months in the combination therapy group; and the difference was statistically significant between the 2 groups ( P = 0.001). Multivariate Cox regression analysis results showed that combination therapy with SDSF and the lowest testosterone level were independent influencing factors of PFS ( P = 0.001). The total cholesterol at 6-, 9-, 12-month in the combination therapy group was lower than that in the monotherapy group (all P < 0.05), triglyceride at 3-, 6-, 9-, 12-month in the combination therapy group was lower than that in the monotherapy group (all P < 0.05); and the differences in fasting blood glucose after treatment at different time points were not statistically significant between the 2 groups (all P > 0.05); I-PSS score at 9-, 12-month in the monotherapy group was lower than that in the monotherapy group (both P < 0.05). Conclusions:The combination of SDSF with endocrinotherapy can delay the progression of mHSPC, improve treatment-related complications, and enhance patients' quality of life.