晚期前列腺癌联合雄激素阻断治疗的长期随访  

Long Term Survival Results in Advanced Prostate Cancer Treated with Combined Androgen Blockade

作　　者：张世革[1] 王益华[2] 丁毅[1] 吴烨[1] 

机构地区：[1]江苏省老年医院泌尿外科,江苏南京210024 [2]南京大学附属鼓楼医院病理科,江苏南京210009

出　　处：《中华男科学杂志》2005年第10期770-771,774,共3页National Journal of Andrology

摘　　要：目的:了解晚期前列腺癌联合雄激素阻断治疗的长期生存率.方法:选取1993年1月～2000年1月初采用联合雄激素阻断治疗的59例前列腺腺癌患者,其中28.81%和45.76%为临床局部晚期(T3-4 NOM0期)和转移(TxNxM+期)病例,全部随访5年以上.结果:全组病例3、5、7年的总体生存率分别是79.36%、61.46%、49.15%,其中,临床局部晚期和转移者的5年生存率分别为80.77%和32.65%,而高分化腺癌和低分化腺癌的5年生存率分别为86.21%和30%(P＜0.01).另外,PSA＞30μg/L时其长期生存率有明显下降趋势.结论:采用内分泌治疗的晚期前列腺癌,病理低分化、临床分期达T3c-4NxMx或TxNxM+期及PSA＞30μg/L均提示预后较差,晚期前列腺癌病例的治疗应综合多因素,选择个体化方案.Objective： To understand long-term survival rate after combined androgen blockade （CAB） in patients with advanced prostate cancer. Methods ： A selected population of 59 patients with advanced prostate cancer were treated with CAB. 28.81% （17/59） of patients had clinical locally advanced disease （stage T3-4N0M0）, and 45.76% （27/59） of patients had metastatic disease（ stage TxNxM ＋ ）. Overall, patients were followed for a median of 62 （range 6-136） months. Results： Of the 59 patients with advanced prostate cancer, 3-year, 5-year and 7-year overall survival rates were 79.36%, 61.46% and 49.15% , respectively. The 5-year survival rate were 80.77% and 32.65% for clinical locally advanced disease and metastatic disease. Specifically, men with poorly differentiated prostate cancer had a 5-year survival of only 30% when compared with men with well-differentiated prostate disease who had a 5-year survival of 86.21%. Conclusion ： Based on these findings, men with poorly differentiated cancer, stage T3c-4NxMx or TxNxM＋ and PSA level above 30 μg/L had a high probability of dying from their advanced prostate cancer.

关 键 词：前列腺癌 联合雄激素阻断 生存率 

分 类 号：R737.25[医药卫生—肿瘤] R977.12[医药卫生—临床医学]