醋酸戈舍瑞林缓释植入剂联合比卡鲁胺片对高龄前列腺癌患者的疗效、认知功能、近期生存率的研究  

Therapeutic Efficacy of Goserelin Acetate Sustained-release Implants Combined with Bicalutamide in the Treatment of Elderly Prostate Cancer Patients and Cognitive Function and Short-term Survival Rate Study

作　　者：蔡波[1] 马利民[1] 郭新[1] 

机构地区：[1]南通大学附属医院泌尿外科,江苏南通226001

出　　处：《中国药房》2018年第3期382-385,共4页China Pharmacy

基　　金：国家自然科学基金资助项目(No.81141056)

摘　　要：目的:研究醋酸戈舍瑞林缓释植入剂联合比卡鲁胺片对高龄(≥70岁)前列腺癌(PCA)患者的疗效及对其认知功能、近期生存率的影响。方法:将2014年11月-2016年11月我院收治的56例PCA患者按随机数字表法分为观察组和对照组,各28例。观察组患者给予醋酸戈舍瑞林缓释植入剂(腹壁皮下注射,3.6 mg/次,1次)联合比卡鲁胺片(口服,50 mg/次,qd)行最大限度雄激素阻断治疗,对照组患者采用去势治疗,术后采取多烯紫杉醇(第1天静脉滴注,75 mg/m2)联合醋酸泼尼松片(第1~21天,口服,5mg/次,bid)进行辅助治疗,两组患者疗程均为3周,并均随访12个月。观察两组患者临床疗效、蒙特利尔认知功能评估表(Mo CA)评分、血清前列腺特异性抗原(PSA)水平及12个月生存率。结果:观察组治疗总有效率为85.72%,显著高于对照组的60.71%,差异有统计学意义(P<0.05)。治疗前,两组患者Mo CA评分、血清PSA水平比较,差异均无统计学意义(P>0.05);疗程结束后,两组患者Mo CA评分均显著降低,但观察组高于对照组,差异有统计学意义(P<0.05);治疗后6、12个月,两组患者血清PSA水平均显著降低,且观察组显著低于对照组,差异有统计学意义(P<0.05),观察组患者治疗后12个月生存率为92.86%,显著高于对照组的64.29%,差异有统计学意义(P<0.05)。结论:采用非类固醇抗雄激素药物治疗高龄PCA效果显著,可减小对患者认知功能损害,改善血清PSA水平,提高治疗效果及近期生存率。OBJECTIVE：To investigate therapeutic efficacy of Goserelin acetate sustained-release implants combined with bicalutamide in the treatment of elderly（ ≥70 years old） prostate cancer patients,and its effects on cognitive function and short-term survival rate. METHODS：A total of 56 prostate cancer patients treated in our hospital from Nov. 2014 to Nov. 2016 were divided into observation group and control group according to random number table,with 28 cases in each group. Observation group was given maximal androgen blokage（MAB）treatment which was Goserelin acetate sustained-release implant（subcutaneous injection of abdominal wall,3.6 mg/times,once）combined with Bicalutamide tablet（orally,50 mg/times,qd）. Control group received surgical castration,and then was given docetaxel（intravenous dripping on 1 st day） combined with Prednisone acetate tablets（1 st-21 st day,orally,5 mg/time,bid）after surgery for adjuvant therapy. Treatment course of 2 groups lasted for 3 weeks,and all patients were followed up for 12 months. Clinical efficacy,Montreal cognitive function assessment table（Mo CA）score,serum prostate specific antigen（PSA）levels and 12-month survival rate were observed in 2 groups. RESULTS：The total response rate of observation group was significantly higher than that of control group,with statistical significance（P〈0.05）. Before treatment,there was no statistical significance in Mo CA score and serum PSA levels between 2 groups（P〉0.05）. After treatment,Mo CA scores of 2 groups were decreased significantly,and the observation group was higher than the control group,with statistical significance（P〈0.05）. 6 and 12 months after treatment,serum PSA levels of 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance（P〈0.05）;12-month survival rate of observation group（92.86%）was significantly higher than that of control group（64.29%）,with statistical significance（P�

关 键 词：非类固醇抗雄激素药物 最大限度雄激素阻断治疗 醋酸戈舍瑞林缓释植入剂 比卡鲁胺片 高龄 前列腺癌 认知功能 近期生存率 

分 类 号：R737.25[医药卫生—肿瘤]