近距离放疗联合间歇性内分泌治疗在局限性前列腺癌治疗中的应用  

Clinical observation: the clinical therapeutic effect of the combining of intermittent endocrine therapy and brachytherapy in localized prostate cancer

作　　者：张国辉[1] 姜涛[2] 李志辉[1] 郑清友[1] 关亚伟[1] 朱立夏[1] 王金萍[1] 贾卓敏[1] 高峰[1] 

机构地区：[1]北京军区总医院泌尿外科,北京100700 [2]北京军区总医院保健科,北京100700

出　　处：《癌症进展》2014年第1期3-8,15,共7页Oncology Progress

摘　　要：目的分析比较近距离125I粒子置入联合间歇性内分泌疗法(intermittent hormonal therapy,IHT)在局限性前列腺癌治疗中的效果。方法回顾2003年1月至2013年7月期间未接受根治性前列腺切除而接受治疗满5年的136例局限性前列腺癌患者,按治疗方式分为单纯间歇性内分泌治疗(A组,46例)、单纯近距离125I粒子置入(B组,42例)和近距离125I粒子置入+间歇性内分泌治疗(C组,48例)三组,分析比较三组患者的治疗无效率、5年无事件生存率和5年生存率。结果 A组、B组、C组治疗无效率分别为17.39%、16.67%、2.08%,5年无事件生存率分别为36.96%、66.67%、87.50%,5年生存率分别为50.00%、73.81%、93.75%。C组的治疗无效率明显低于A组和B组,差异有统计学意义(P<0.05);C组的5年无事件生存率和5年生存率明显高于A组和B组,差异均有统计学意义(P<0.05);C组的不良反应发生率明显低于B组,差异有统计学意义(P<0.05)。结论近距离125I粒子置入联合间歇性内分泌治疗作为局限性前列腺癌的综合治疗手段,可以增加治疗有效率、提高无事件生存率和生存率,是局限性前列腺癌安全有效的治疗方法。Objective To investigate the clinical therapeutic effect of the combining of intermittent endocrine therapy and brachytherapy in localized prostate cancer. Method A total of 136 localized prostate cancer patients who had received 5-year treatment without radical prostateetomy from January 2003 to July 2013 were retrospectively analyzed. All patients were divided into three groups based on therapy： A group （46 cases） received intermittent endocrine therapy; B group （42 cases） accepted 125I brachytherapy; And C group （48 cases） was applied with 125I brachytherapy ＋ intermittent endotrine therapy. Anti the inefficieney, 5-year event-free survival rate and 5-year overall survival rate of the three groups were compared. Result The inefficiency in A group, B group, C group was 17.39%, 16. 67%, 2.08%, while 5-year event-free survival rate was 36. 96%, 66. 67%, 87. 50%, and 5-year survival rate was 50. 00%, 73.81%, 93.75%., respectively. The inefficiency of C was lower than A and B （ P〈0. 05）, but the 5-year event-free survival rate and 5-year survival rate in C were statistically better than A and B （P〈0. 05） ; And the adverse reaction in C was statistically less than B （P〈 0. 05）. Conclusion As a comprehensive therapy, the combination of intermittent endocrine therapy and 125I brachytherapy can increase response rate, event-free survival rate anti overall survival rate, and is an effective and safe treatment for localized prostate cancer.

关 键 词：近距离125I粒子置入 间歇性内分泌治疗 局限性前列腺癌 

分 类 号：R737.25[医药卫生—肿瘤] R730.58[医药卫生—临床医学]