前列腺癌间歇内分泌治疗预后因素分析  

Analysis of prognoseic factor on intermittent hormonal therapy for patients with prostate cancer

作　　者：韩铖琛[1] 高旭[1] 孙颖浩[1] 

机构地区：[1]第二军医大学第一附属医院长海医院泌尿外科,上海200433

出　　处：《国际泌尿系统杂志》2013年第4期442-444,共3页International Journal of Urology and Nephrology

摘　　要：目的 探讨患者基础情况、PSA动态变化参数等指标对前列腺癌间歇内分泌治疗预后的分析价值.方法 回顾性分析130例符合纳入标准的,采用间歇内分泌治疗方法的前列腺癌患者,进行全雄激素阻断,待PSA小于0.2 ng/mL3 ～6个月后停止用药,再根据每月PSA的检测结果决定是否再行内分泌治疗.如果PSA持续升高且大于10ng/mL,就再次启用内分泌治疗.结果 nPSA小于0.1 ng/mL的患者,从开始间歇内分泌治疗到转变为去势难治性前列腺癌（CRPC）的时间明显延长,RR值为1.487（P=0.036）；PSAV小于-15ng·（mL·year）-1的患者,从开始间歇内分泌治疗到转变为CRPC的时间明显延长,RR值为2.636（P=0.043）.结论 对于第一循环能达到nPSA小于0.1ng/mL,PSAV小于-15ng.（mL·year-1的前列腺癌患者,间歇内分泌治疗的效果更好.Objectives To investigate the efficacy of the intermittent hormonal therapy （IHT） in the treatment of prostate cancer.Methods The IHT materials 130 cases of patients with prostate cancer were analyzed retrospectively,the cases must be satisfying the condition that has been settled.Maximal androgen blockade （MAB） therapies were used for several months,and then stopped until the serum prostate specific antigen （PSA） was decreased below 0.2ng/mL,which lasted for three months to six months.It was decided whether MAB went on according to if the level I of PSA is higher than 10ng/mL.Analyze the information of intermittent hormonal therapy and the time arriving CRPC to find the Predicative factors that related to the effect of the intermittent hormonal therapy.Results The average follow up time was 1063 ± 682 days.Ninety five patients started the second cycle of treatment,thirty nine patients started the third cycle and thirteen entered the fourth.The patients with nPSA below 0.1 ng/mL or PSAV below-15ng/mL/year experienced longer time to change to CRPC.PSAV and nPSA are the independent risk factors for the time cost for turning to CRPC.Conclusions The analysis of the Prediction of intermittent hormonal therapy efficacy indicates that nPSA and PSAV are the independent factors that predicate the efficacy of intermittent hormonal therapy.Intermittent hormonal therapy is more effective and proper for the patient with nPSA 〈0.1 ng/mL or PSAV 〈-15ng/mL/year.

关 键 词：前列腺肿瘤 预后 

分 类 号：R737.25[医药卫生—肿瘤]