睾丸切除联合缓退瘤与单纯睾丸切除治疗进展性前列腺癌的疗效评估  

The Evaluation of Orchiectomy Plus Flutamide and Pure Orchiectomy in Reatment of Metastatic Prostatic Cancer

作　　者：杜涛[1] 姬彤宇[1] 

机构地区：[1]河南省人民医院泌尿外科,郑州市450003

出　　处：《河南医药信息》2001年第4期1-3,共3页Henan Medical Information

摘　　要：目的 :评估睾丸切除联合缓退瘤与单纯睾丸切除治疗进展性前列腺癌的疗效。方法 :6 5例进展性前列腺癌病人中筛选了 5 5例进行评估。其中睾丸切除联合缓退瘤治疗的 30例 ,为A组 ;单纯睾丸切除治疗的 2 5例 ,为B组。所分析的主要疗效指标为客观治疗反应、进展间隔时间和两年生存率。对单项疗效评估指标包括全身情况、扩散性疼痛、AKP和PAS水平以及骨转移范围也进行了分析。评估A组和B组两组疗效的差异。结果 :如果以病变消退为治疗反应 ,A组的反应率为 43%而B组为 2 5 % (P <0 .0 0 1) ;若以病变消退和稳定为治疗反应 ,则A组的反应率为 77%而B组为 6 5 % (P <0 .0 0 5 )。平均主观进展时间 :A组为 16 .3± 5 .5个月而B组为 15 .8± 5 .8个月 (P >0 .0 5 ) ;平均客观进展时间 :A组为 18.2± 5 .3个月而B组为 17.6± 5 .7个月 (P >0 .0 5 )。两年生存率 :A组 36 %而B组 33 % (P >0 .0 5 )。在分析单项疗效评估指标时发现 :除全身情况外 ,A组较B组有显著性差异。结论 :睾丸去势仍然是前列腺癌内分泌治疗的金标准。睾丸切除联合缓退瘤治疗在病变的消退和稳定、扩散性疼痛的缓解、AKP和PSA的水平的恢复和骨转移范围缩小方面较单纯睾丸切除有较好的效果。但是 ,就进展时间和生存率而言并无更大的价值。Purpose :To evaluate the efficacies of orchiectomy plus flutamide and pure orchiectomy in the treatment of metastatic prostatic cancer.Materials and Methods:From 1983 to 1998,there were 65 patients with metastatic prostatic cancer treated at our department.55 examples were to be evaluated.In these patients,30 examples treated with orchiectomy plus flutamide were designed as group A,and 25 examples with pure orchiectomy,designed as group B.The main efficacy criteria including objective response to treatment,interval to progression,and two-year survival were analyzed.Individual response criteria including pain of metastatic origin,levels of AKP and PSA,and range of bone involvement were also analyzed.The differences of efficacy between group A and group B were evaluated.Results:If regression of disease was considered as objective response to treatment,the percentage of response was 43% in group A and 25% in group B ([WT5”BX]P[WT5”BZ]<0.001).If regression and stability of the disease were considered as objective response to treatment,the percentage of response was 77% in group A and 65% in group B([WT5”BX]P[WT5”BZ]<0.005).The mean interval to subjective progression was 16.3±5.5 months in group A and 15.8±5.8 months in group B([WT5”BX]P[WT5”BZ]>0.05).The mean interval to objective progression was 18.2±5.3 months in group A and 17.6±5.7 months in group B([WT5”BX]P[WT5”BZ]>0.05).The two-year survival was 36% in group A and 33% in group B([WT5”BX]P[WT5”BZ]>0.05).Significant differences in favor of the group A were found in analyzing the individual response criteria except performance status.Conclusions:Castration remains the gold standard of endocrine treatment.The combination of orchiectomy and flutamide has a more beneficial effect on pain of metastatic origin,

关 键 词：缓退瘤 睾丸切除 前列腺癌 治疗 

分 类 号：R737.25[医药卫生—肿瘤] R730.5[医药卫生—临床医学]