前列腺癌晚期PSA水平变化及内分泌治疗的临床分析  

Clinical analysis of changes in the PSA levels of and effect of endocrine therapy for patients with advanced prostate cancer

作　　者：刘军 沈宁博 刘涛 熊飞 颜昭君 LIU Jun;SHEN Ningbo;LIU Tao;XIONG Fei;YAN Zhaojun(Department of Urology,Dangyang People's Hospital,Yichang 444100,Hubei,China;Department of Urology,Yichang Central Hospital,Yichang 443613,Hubei,China;Department of Pharmacy,Jingzhou Hospital of Traditional Chinese Medicine,Jingzhou 434000,Hubei,China)

机构地区：[1]当阳市人民医院泌尿外科,湖北宜昌444100 [2]宜昌市中心医院泌尿外科,湖北宜昌443613 [3]荆州市中医医院药剂科,湖北荆州434000

出　　处：《中国性科学》2019年第2期5-9,共5页Chinese Journal of Human Sexuality

基　　金：湖北省卫生科研基金资助项目(2008Z-Y28)

摘　　要：目的探究晚期前列腺癌患者血清PSA水平变化以及不同内分泌治疗方案的治疗效果。方法选取2009年2月至2012年6月当阳市人民医院诊治的晚期前列腺癌患者119例作为研究对象。按照内分泌治疗方案的不同分为IHT组(63例)和CHT组(56例)。对比两组患者在内分泌治疗后的PSA水平变化、临床疗效、药物不良反应以及生存质量状况。结果 HIT组患者在治疗后6个月的血清PSA水平明显高于CHT组,差异具有统计学意义(P<0.05),两组患者在治疗后12个月、18个月以及24个月的血清PSA水平均未见显著差异(P>0.05)。IHT组患者的排尿症状、治疗相关症状及性功能等方面评分明显优于CHT组,差异具有统计学意义(P<0.05),两组患者在肠道症状、骨痛方面评分差异无统计学意义(P>0.05)。IHT组患者在治疗期间的不良反应发生率为20.63%,明显高于CHT组(44.64%),差异具有统计学意义(P<0.05)。IHT组及CHT组患者的3年生存率分别为80.95%、76.19%,差异无统计学意义(P>0.05)。IHT组患者的出现进展以及处于去势抵抗的比例分别为23.81%、19.05%,均明显低于CHT组(分别为39.68%、41.27%),差异比较有统计学意义(P<0.05)。结论行间歇性内分泌治疗后,晚期前列腺的血清PSA水平逐渐趋于正常,能够获得与持续性内分泌治疗相同的临床疗效。间歇性内分泌治疗因其较低的药物不良反应能够使患者的的生存质量状况得到显著改善。Objective To study the changes in serum PSA levels and therapeutic effects of different endocrine therapies for patients with advanced prostate cancer.Methods 119 patients with advanced prostate cancer who were treated with endocrine therapy in our hospital were selected as the research objects.According to the different endocrine treatment regimens,the patients were divided into IHT group(63 cases)and CHT group(56 cases).The changes in PSA levels,clinical efficacy,adverse reactions and quality of life were compared between the two groups after endocrine therapy.Results The serum PSA levels of IHT group were significantly higher than that in CHT group at 6 months after treatment(P<0.05).There were no significant differences in serum PSA levels between the two groups at 12 months,18 months and 24 months after treatment(P>0.05).The urinary symptoms,treatment related symptoms and sexual function score in IHT group were significantly higher these in CHT group,with statistically significant difference(P<0.05).And there was no significant difference in the scores of intestinal symptoms and bone pain(P>0.05).The incidence of adverse reactions in IHT group was 20.63%,which was significantly higher than that in CHT group(44.64%),with statistically significant difference(P<0.05).The 3-year survival rates of IHT group and CHT group were 80.95%and 76.19%respectively,without statistically significant difference(P>0.05).The rates of progression and castration resistance in IHT group were 23.81%and 19.05%respectively,which were significantly lower than those in CHT group(39.68%and 41.27%,respectively),and the differences were statistically significant(P<0.05).Conclusions After intermittent hormonal thera-py,the level of serum PSA decreases gradually and returns to normal level in the patients with advanced prostate cancer,with the same long-term effect as continuous hormonal therapy.Moreover,intermittent endocrine therapy can significantly improve the quality of life of patients because of its low adverse reactions.

关 键 词：晚期前列腺癌 血清前列腺特异抗原 间歇性内分泌治疗 持续性内分泌治疗 

分 类 号：R698[医药卫生—泌尿科学]