晚期前列腺癌持续与间歇内分泌治疗的疗效和不良反应比较  

Therapeutic effects and adverse reactions of continuous or intermittent endocrine therapy in treatment of advanced prostate cancer

作　　者：姜军 李金明 郑国昌 白续国 JIANG Jun;LI Jinming;ZHENG Guochang(The First Hospital of Xingtai City,Hebei, Xingtai 054001,China)

机构地区：[1]邢台医学高等专科学校第一附属医院

出　　处：《河北医药》2020年第1期70-73,共4页Hebei Medical Journal

摘　　要：目的分析晚期前列腺癌持续与间歇内分泌治疗的临床疗效和不良反应,为临床治疗提供参考。方法2014年1月至2019年5月收治的晚期前列腺癌首先进行6个月雄激素全阻断内分泌治疗,进行疗效评估,将对内分泌治疗有效的患者随机分为间歇组和持续组,对比2组患者治疗前后的血清前列腺特异性抗原(PSA)变化、药物不良反应情况、治疗前后生活质量变化及疾病进展为去势抵抗性前列腺癌的比例。结果共收治114例晚期前列腺癌患者,其中对内分泌治疗敏感107例,入组间歇组53例,入组持续组54例。2组前列腺癌患者不同治疗时间血清PSA水平均较治疗前显著下降(P<0.05)。治疗中间歇组不良反应发生率为20.75%显著低于持续组的38.88%(P<0.05)。间歇组患者WHOQOL-100生活质量评分明显优于持续组(P<0.05)。间歇组患者进展为去势抵抗性前列腺癌的比例为39.62%显著低于持续组的进展比例64.81%(P<0.05)。结论间歇性内分泌治疗晚期前列腺癌,可在有效治疗疾病的同时降低药物不良反应,提高患者的生活质量,可推迟进展为去势抵抗性前列腺癌的时间,具有临床推广使用价值。Objective To investigate the therapeutic effects and adverse reactions of continuous or intermittent endocrine therapy in treatment of advanced prostate cancer,so as to provide reference for clinical treatment.Methods A total of 114 patients with advanced prostate cancer who were admitted and treated in our hospital form January 2014 to May 2015 were enrolled in the study,firstly,these patients were treated by androgen complete blocking endocrine therapy,then who were randomly divided into control group and observation group.The changes of serum prostate-specific antigen(PSA),adverse drug reactions,the changes of life of patients quality before and after treatment,and the percentage of disease progression to castration-resistant prostate cancer(CRPC)were observed and compared between the two groups.Results Among the 114 patients,107 patients were sensitive to endocrine therapy,of whom,53 patients were treated by intermittent endocrine therapy,and the other 54 patients were treated by continuous endocrine therapy.After treatment the serum levels of PSA in different time points were significantly decreased in both groups,as compared with those before treatment(P<0.05).And the incidence rate of adverse reactions(20.75%)in observation group was significantly lower than that(38.88%)in control group(P<0.05).Moreover the life quality scores in intermittent endocrine therapy group were significantly higher than those in continuous endocrine therapy group(P<0.05),and the percentage of disease progression to CRPC in intermittent endocrine therapy group were significantly lower than that in continuous endocrine therapy group(39.62%vs 64.81%,P<0.05).Conclusion The intermittent endocrine therapy in treatment of advanced prostate cancer can effectively reduce the adverse drug reactions,and improve the life quality of patients,which can effectively delay the progression of CRPC,thus,which is worthy of clinical application and promotion.

关 键 词：晚期前列腺癌 持续性内分泌治疗 间歇性内分泌治疗 去势抵抗性前列腺癌 

分 类 号：R737.25[医药卫生—肿瘤]