Analysis Of Oncology Efficacy Of Different Androgen Deprivation Treatments In Hormone-sensitive Prostate Cancer Patients

Objective:To compare the oncological outcomes of GnRH receptor antagonists and GnRH receptor agonists combined with androgen blockade therapy as an androgen deprivation treatment in hormone-sensitive prostate cancer patients.Methods:Collect clinical data of hormone-sensitive prostate cancer patients who underwent endocrine therapy for prostate cancer in our hospital From January 1,2013 to December 31,2020.All patients were pathologically diagnosed with prostate cancer and were sensitive to endocrine therapy.Hospitalization data And follow-up information is relatively complete.Patients are divided into GnRH receptor antagonist group and GnRH receptor agonist group according to the different ADT regimens,the GnRH receptor antagonist group is degarelix monotherapy,while the agonist group is GnRH agonist combined with androgen blockade therapy.According to whether the patient’s clinical stage is metastatic prostate cancer,whether the initial PSA value is more than 50ng/ml,and whether the Gleason score is more than 7.Collect the patient’s hospitalization data and follow-up data including: patient’s age,height,weight,initial PSA value,prostate puncture Gleason score,imaging data before endocrine therapy;serum PSA value,testosterone level,clinical symptoms,imaging during treatment Inspection results,survival status,etc.The PSA value after7 months of treatment,PSA progression-free survival,imaging progression-free survival,clinical progression-free survival,overall survival and other oncology outcome indicators were compared and analyzed.Results:According to the inclusion and exclusion criteria,a total of 198 patients with hormone-sensitive prostate cancer were collected,among which 157 patients who used GnRH receptor agonists(leuprolide,goserelin,triptorelin,etc.)as castration treatment drugs,after propensity score match(PSM),41 patients were included in the GnRH agonist group;41 patients who used GnRH receptor antagonist(degarelix)as castration therapy were included in GnRH antagonist Agent group.In the survival analysis,patients in the GnRH antagonist group were slightly better than the GnRH agonist group in terms of PSA progression-free survival(P=0.0387),but not in terms of imaging progression-free survival,clinical progression-free survival,and overall survival.A statistical difference was observed.In a further subgroup analysis,it was found that the PSA progression-free survival in patients with Gleason score>7 and the clinical progression-free survival in patients with metastatic prostate cancer in the GnRH antagonist group were slightly longer than those in the GnRH antagonist group(P =0.0487,P=0.0384).On the other hand,among patients with metastatic prostate cancer,the incidence of clinical progression in the GnRH antagonist group was relatively lower than that in the GnRH agonist group(11/25 VS 21/28,P=0.021).There was no statistical difference in the incidence of oncology outcome events in the remaining subgroups.Conclusion:Both GnRH receptor antagonists and GnRH receptor agonists combined with antiandrogens can be used as androgen deprivation treatment options for prostate cancer,and their oncological effects are basically equivalent.GnRH antagonists show potential advantages in controlling the progression of PSA.In patients with metastatic prostate cancer,GnRH antagonists have better performance in controlling clinical progress,suggesting that for patients with metastatic prostate cancer,antagonists are expected to enable patients to achieve better asymptomatic survival.