晚期前列腺癌治疗的回顾研究  

Retrospective study on treatment of advanced prostate cancer

作　　者：马永康 何朝宏 杨铁军 田沛 

机构地区：[1]郑州大学附属肿瘤医院泌尿外科,郑州450003

出　　处：《医药论坛杂志》2014年第3期30-31,共2页Journal of Medical Forum

摘　　要：目的比较间歇性雄激素阻断治疗(IAD)和持续性雄激素阻断治疗(CAD)在有骨转移的前列腺癌(PCA M≥1)的疗效以及不良反应。方法回顾2011年1月至2013年1月郑州大学附属肿瘤医院收治的90例前列腺癌患者,均经前列腺穿刺活检病理确诊为前列腺癌,ECT骨扫描证实有骨转移。其中44例患者采用皮下注射戈舍瑞林+口服比卡鲁胺(IAD组),46例患者采用双侧睾丸切除+口服比卡鲁胺(CAD组),当PSA<0.2ug/L后,持续用药3个月停药,进入间歇期。待PSA>4ng/ml后进入下一周期的治疗。比较两组患者由雄激素依赖性前列腺癌进展为雄激素非依赖性前列腺癌的时间、在治疗过程中生活质量以及不良反应的发生率。结果其中CAD组和IAD组患者发展为雄激素非依赖性前列腺癌的时间分别为(14.54±5.41)个月和(14.37±5.38)个月,两组的差别无统计学意义(P=0.885>0.05),CAD组患者潮热、乳房疼痛的发生率分别为52.2%和45.7%,IAD组为20.5%和18.2%。P<0.05差别有统计学意义。结论 IAD治疗在效果上与CAD大致相同,可在一定程度上缓解雄激素阻断治疗带来的副作用,提高生活质量。Objective To compare the curative effect and adverse reaction of intermittent androgen deprivation therapy （IAD） and continuous androgen deprivation therapy（CAD） in metastatic prostate cancer（ PCA, M I〉 1 ）. Methods To- tally 90 cases of prostate cancer back in 2011 January to 2013 January in our hospital, were confirmed by biopsy of the prostate pathological diagnosis of prostate cancer, ECT bone scan confirmed with bone metastasis. 44 patients were trea- ted with orchiectomy and oral bicalutamide （CAD group） ,46 patients with subcutaneous injection of goserelin plus oral bicalutamide（group IAD）,when PSA 〈 0. 2ug/L, lasted for three months to stop drug, in intermittent period. When PSA 〉 4ug/L into the treatment of the next cycle. The occurrence rate of the two groups were compared by the androgen dependent prostate cancer progression to androgen independent prostate. Results The CAD group and the IAD group patients develop androgen independent prostate cancer were （ 14. 54 ± 5. 41 ） and （ 14. 37 ±5. 38 ） months, two groups had no significant difference（ P = 0. 885 〉 0. 05 ）, incidence rates were 52. 2% and 45.7% CAD patients with hot flashes, breast pain,IAD 20. 5% and lg. 2%. The difference was significant,P 〈0. 05. Conclusion IAD treatment in effect and there were no significant differences in CAD, to a certain extent, ease the androgen deprivation therapy brought side - effects, improve the quality of life;

关 键 词：前列腺癌 持续性雄激素阻断治疗 间歇性雄激素阻断治疗 无进展时间 

分 类 号：R737.35[医药卫生—肿瘤]