老年前列腺癌患者长期内分泌治疗对停药后性激素恢复及预后的影响  

Effects of cessation of long-term androgen deprivation therapy on the recovery and prognosis of the elderly patients with prostate cancer

作　　者：周训荣[1] 武程[1] 奚鹏山[1] 唐庆生[1] 夏安乐[1] 常平安[1] 周松林[1] 何斌[1] 周晓畏[1] 倪浩东[1] 

机构地区：[1]江苏省东台市人民医院泌尿外科,江苏盐城224200

出　　处：《临床泌尿外科杂志》2017年第4期306-309,共4页Journal of Clinical Urology

摘　　要：目的:探讨长期内分泌治疗(ADT)老年前列腺癌患者停止ADT后性激素水平恢复情况。方法:回顾性分析2008年1月~2013年12月我院泌尿外科诊治的37例局限性浸润或转移前列腺癌患者的临床资料,所有患者均长期行ADT,在停止ADT治疗后进行长期随访观察并定期检测黄体生成素(LH)、睾酮(T)。结果:ADT停止后18个月,所有患者LH均超过去势水平(>1.1U/L),而仍有40.5%患者睾酮仍处于去势水平(<50ng/dl)。ADT撤停后30个月,尽管LH水平正常,32.4%患者睾酮水平仍<50ng/dl。多因素分析得出,ADT时间是唯一与睾酮恢复显著相关的变量。显著区分睾酮恢复>50ng/dl的ADT时间阈值为60个月。根据ADT时间(<60个月与≥60个月)建立分组,采用Kaplan-Meier曲线分析无睾酮恢复的生存状况。ADT少于60个月患者无睾酮恢复的平均生存时间是15.7个月(95%CI 6.6~22.1个月),而ADT超过60个月患者无睾酮恢复的平均生存时间是30.1个月(95%CI 18.9~39.6个月),Log-rank P=0.042。结论:年龄与ADT停止后睾酮恢复(>50ng/dl)没有显著相关性,老年前列腺癌患者进行ADT超过60个月,此后停药睾酮仍可很长时间内保持去势水平。Objective： To evaluate hormonal recovery after cessation of androgen deprivation therapy （ADT） in elderly prostate cancer patients. Method.. A retrospective review was carried out on 37 patients with locally ad- vanced or metastatic prostate cancer who had undergone endocrine therapy from Jan. 2008 to Dec. 2013. Serum testosterone and luteinizing hormone （LH） were determined regularly after ADT cessation. Resultt After 18 months of follow-up period, all patients had recovered normal LH level, while 40.5% of patients still presented castration level of testosterone （〈50 ng/dl）. Despite normalization of LH level, 32.4% of patients still had testosterone level lower than 50 ng/dl 30 months after find that only duration of ADT was correlated with ADT withdrawal. A multivariate analysis was performed to testosterone recovery. Kaplan-Meier curves were obtained. Mean time for testosterone recovery was 15.7 months （95M CI 6.6-22.1 months） in patients treated with ADT for less than 60 months compared to 30.1 months （95M CI 18.9-39.6 months） in patients treated with ADT for more than 60 months （Log-rank, P=0. 042）. Conclusion： Age did not correlate with testosterone recovery in a group of elderly prostate cancer patients in whom ADT was stopped. Testosterone recovery after ADT cessation was significantly correlated with duration of ADT.

关 键 词：内分泌治疗 前列腺癌 睾酮 性激素 

分 类 号：R737.25[医药卫生—肿瘤]