高危组前列腺癌根治术后雄激素剥夺治疗联合早期放射治疗对局部控制及近期生存率的影响  

Effect of early radiotherapy combined with androgen deprivation therapy after radical prostatectomy on local control and survival in patients with high-risk prostate cancer

作　　者：靳松[1] 张天[2] 郑颖洁[2] 宋黎明[1] 平浩[1] 瓦斯里江.瓦哈甫 牛亦农[1] 邢念增[1] 

机构地区：[1]首都医科大学附属北京朝阳医院泌尿外科,北京100020 [2]首都医科大学附属北京朝阳医院放疗科,北京100020

出　　处：《首都医科大学学报》2016年第3期318-322,共5页Journal of Capital Medical University

基　　金：北京市卫生系统高层次卫生技术人才(2011-3-014)~~

摘　　要：目的探讨内分泌治疗合并早期放射治疗对高危前列腺癌患者根治术后的局部控制及近期生存率的影响。方法收集首都医科大学附属北京朝阳医院14例高危组前列腺癌根治术后行三维适形放射治疗（three dimension-conformal radiotherapy,3D-CRT）或调强放射治疗（intensive modulation radiotherapy,IMRT）联合内分泌治疗的患者,收集患者基本信息、手术信息,并随访放射治疗期间的相关合并症、术后及放射治疗后前列腺特异性抗原（prostate specific antigen,PSA）变化与生存状态,并进行统计学分析。结果 14例患者治疗后随访时间2～52个月,平均随访时间20个月。在放射治疗疗期间,5例患者出现轻度尿频、尿急,2例出现轻度腹泻、腹胀,1例患者出现白细胞一过性降低,血红蛋白、血小板无异常,无其他合并症发生;1例患者放射治疗疗后24个月,PSA由最低0.056 ng/m L升高至6 ng/m L,但无明显局部复发和远处转移迹象,恢复比卡鲁胺及亮丙瑞林治疗5个月后,PSA降至1.539 ng/m L。其他13例患者无生化指标反弹及临床局部复发。结论高危前列腺癌根治术后,早期辅助放射治疗联合内分泌治疗可以改善患者局部控制及近期生存率。Objective To investigate the effect of radiotherapy combined with androgen deprivation therapy after radical prostatectomy on local control and survival in patients with high-risk prostate cancer. Methods Fourteen patients with high-risk prostate cancer seen from 2010 to 2015 were treated with three dimension-conformal radiotherapy（ 3D-CRT） or intensive modulation radiotherapy（ IMRT）combined with androgen deprivation therapy after radical prostatectomy. The basic information,surgery,radiotherapy complications,prostate specific antigen（ PSA） after surgery and survival condition of the patients were collected. Results Mean follow-up period was 20（ 2-52） months. During radiotherapy,no severe complications occurred in the fourteen treated patients,5 patients had mild frequent or urgent urination,2 patients had mild diarrhea and abdominal distension,and only 1 patient had transient reduced leucocyte count without abnormal hemoglobin and platelet. PSA increased to 6 ng / m L from 0. 056 ng / m L after radiotherapy without local recurrence and metastasis in one patient who resumed taking androgen deprivation therapy（ bicalutamide and leuprorelin） for 5 months and PSA decreased to 1. 539 ng / m L. The other 13 patients survived without biochemical and local recurrence. Conclusion Early adjuvant radiotherapy combined with androgen deprivation therapy after radical prostatectomy improve the local control and survival in the patients of high-risk prostate cancer.

关 键 词：高危前列腺癌 前列腺癌根治术 放射治疗 雄激素剥夺治疗 

分 类 号：R737.25[医药卫生—肿瘤]