抗雄激素药物替换治疗对去势抵抗性前列腺癌患者前列腺特异抗原的影响  

The Effect of Anti-androgen Replacement Therapy on Prostate Specific Antigen in Patients with Castration-resistant Prostate Cancer

作　　者：贝为新 李仙 黎德林 钟启值 黄志红 黄恒海 BEI Weixin;LI Xian;LI Delin;ZHONG Qizhi;HUANG Zhihong;HUANG Henghai(Department of Urology,Wuzhou Workers'Hospital,Wuzhou,Guangxi,Zhuang Autonomaus Region,543000 China)

机构地区：[1]梧州市工人医院泌尿外科,广西梧州543000

出　　处：《中外医疗》2021年第9期95-97,共3页China & Foreign Medical Treatment

摘　　要：目的探讨抗雄激素药物替换治疗对去势抵抗性前列腺癌患者前列腺特异抗原的影响。方法方便选取该院于2017年1月—2020年2月间收治的去势抵抗性前列腺癌患者96例,以回顾性分析形式,记录96例患者停用抗雄激素药物(氟他胺或比卡鲁胺)后,改为戈舍瑞林或者亮丙瑞林的临床效果。统计抗雄激素撤退治疗有效率、抗雄激素撤退发生率、效果的潜在预测因素。结果96例去势抵抗性前列腺癌患者中,共计有24例出现抗雄激素撤退反应(前列腺特异抗原降低程度≥50.00%),抗雄激素撤退治疗有效率为25.00%(24/96),疾病缓解的平均用时为(4.05±1.96)个月。初始内分泌治疗中,应用氟他胺治疗的患者其抗雄激素撤退反应发生率在32.00%(16/50),应用比卡鲁胺患者的抗雄激素撤退反应发生率为17.39%(8/46),两组对比差异无统计学意义(χ^(2)=2.727,P=0.099);治疗前存在骨或者软组织转移的患者为42例,抗雄激素撤退发生率14.29%(6/42),无骨或者软组织转移54例,抗雄激素撤退发生率33.33%(18/54),组间对比差异有统计学意义(χ^(2)=4.571,P=0.032);患者的年龄情况、抗雄激素药物应用情况、GLeason分级情况、TNM分级情况、是否有骨或软组织转移情况、初始内分泌治疗用时、治疗前血清前列腺特异抗原以及血清睾酮等和治疗是够有效没有关联。结论抗雄激素撤退治疗对少数去势抵抗性前列腺癌患者,可先用抗雄激素撤退处理。Objective To investigate the effect of anti-androgen replacement therapy on prostate specific antigen in patients with castration-resistant prostate cancer.Methods Convenient select a total of 96 castration-resistant prostate cancer patients were admitted to the hospital from January 2017 to February 2020.In the form of retrospective analysis,96 patients who stopped using anti-androgen drugs(flutamide or bicalutamide)were recorded,the clinical effect of goserelin or leuprolide.Statistics of the effective rate of anti-androgen withdrawal treatment,the incidence of anti-androgen withdrawal,and the potential predictors of the effect.Results Among 96 castration-resistant prostate cancer patients,a total of 24 patients had anti-androgen withdrawal reactions(prostate specific antigen reduction≥50.00%),and the effective rate of anti-androgen withdrawal treatment was 25.00%(24/96).The average time for disease remission was(4.05±1.96)months.In initial endocrine therapy,the incidence of anti-androgen withdrawal reactions in patients treated with flutamide was 32.00%(16/50),and the incidence of anti-androgen withdrawal reactions in patients treated with bicalutamide was 17.39%(8/46),the comparison between the two groups was not statistically significant(χ^(2)=2.727,P=0.099);42 patients had bone or soft tissue metastasis before treatment,the incidence of anti-androgen withdrawal was 14.29%(6/42),and there was no bone or soft tissue 54 cases of metastasis,the incidence of anti-androgen withdrawal was 33.33%(18/54),the comparison between groups was statistically significant(χ^(2)=4.571,P=0.032);the patient’s age,anti-androgen application,GLeason classification,TNM classification,whether there is bone or soft tissue metastasis,the time of initial endocrine therapy,serum prostate specific antigen and serum testosterone before treatment,etc.are not related to whether the treatment is effective.Conclusion Anti-androgen withdrawal treatment can be treated with anti-androgen withdrawal first for a small number of castration-r

关 键 词：抗雄激素药物 去势抵抗性前列腺癌 前列腺特异抗原 影响分析 

分 类 号：R5[医药卫生—内科学]