白膜下睾丸实质剜除术与药物去势治疗Ⅳ期前列腺癌疗效回顾性研究  

Retrospective study of therapeutic efficacy of subcapsular orchiectomy and medical castration in prostate cancer patients-Ⅳ

作　　者：赖彩永[1] 蒋光愉[2] 苏泽轩[3] 李立[3] 李红[2] 梁蔚波[3] 卓育敏[3] 郭泽雄[3] 李宇同[3] 陈洁[3] 徐谊朝[3] 傅全胜[3] 张燊[3] 刘玉峰 邹自灏[4] 黄伟佳[4] 

机构地区：[1]南方医科大学研究生院,广州广东510515 [2]暨南大学附属第一医院临床病理科,广州广东510630 [3]暨南大学附属第一医院泌尿外科,广州广东510630 [4]广州医学院第三附属医院泌尿外科,广州广东510150

出　　处：《中国现代医学杂志》2012年第24期52-55,共4页China Journal of Modern Medicine

基　　金：广州市医药卫生科技项目(No:2012IA011159);国家高新技术研究发展计划(863计划)子课题(No:2007AA022006)

摘　　要：目的回顾性分析白膜下睾丸实质剜除术与药物去势治疗Ⅳ期前列腺癌的疗效及副作用的差异。方法 2005年01月～2011年10月采用白膜下睾丸实质剜除术(n=70)和诺雷德联合康士得(n=62)治疗Ⅳ期前列腺癌并进行随访,分析其肿瘤缓解时间、总生存时间、手术并发症及对患者心理的影响。结果随访时间1～59个月,手术组和药物组肿瘤缓解时间分别为18个月和17个月,两组差异无显著性(χ2=0.166,P=0.682),总生存时间分别为33个月和31个月,两组差异无显著性(χ2=0.080,P=0.778)。手术组发生术后并发症的比率为10%,没有出现因睾丸切除导致的心理疾病。结论白膜下睾丸实质剜除术作为Ⅳ期前列腺癌白膜下睾丸实质剜除方法,具有疗效确切、对心理影响少及成本低的特点,可作为Ⅳ期激素依赖型前列腺癌去势治疗的首选方法。【Objective】 To explore retrospectively the difference of therapeutic efficacy and side effect between subcapsular orchiectomy and medical castration in prostate cancer Patients-Ⅳ.【Methods】 In the retrospective study,132 consecutive Patients-Ⅳ were evaluated,the operation group（n =70） had primarily been treated by subcapsular bilateral orchiectomy and the medicine group（n =62） had received medical castration from Jan 2005～Oct 2011.Response to therapy,time of tumor remission,overall survival time,psychological disorders due to loss of organ and postoperative surgical complications were recorded.【Results】 The follow up time was 1～59 months.Median time of tumor remission of the operation group and medicine group were 18 and 17 months.The difference was statistically insignificant（χ2=0.166,P =0.682）.Median times of overall survival were 33 and 31 months respectively.The difference was statistically insignificant（χ2=0.080,P =0.778）.10% of the operation group showed minor postoperative complications.No psychological disease occurred following bilateral orchiectomy.【Conclusion】 Due to an effective and persistent oncological effectiveness,absence of psychological complications and cost-effective,bilateral subcapsular orchiectomy seems to be a practicable and advisable alternative in the first-line therapy of prostate cancer Patients-Ⅳ.

关 键 词：白膜下睾丸实质剜除术 Ⅳ期前列腺癌 肿瘤缓解时间 总生存时间 心理疾病 

分 类 号：R737.25[医药卫生—肿瘤]