机构地区:[1]江苏大学医学院,江苏镇江212013 [2]江苏省徐州市中心医院泌尿外科,江苏徐州221009 [3]徐州医科大学临床学院,江苏徐州221009
出 处:《中国医药导报》2022年第11期103-106,共4页China Medical Herald
基 金:国家重点研发计划项目(2017YFC0908000);江苏省医学创新团队项目(CXTD-2017-48);江苏省徐州市卫生创新(技术攻关)团队项目(XWCX201603);江苏省徐州市引进临床专家团队项目项目(2018TD004)。
摘 要:目的评价前列腺癌根治术后出现生化复发患者行放射治疗联合内分泌治疗的效果。方法选取2010年1月至2018年12月在江苏省徐州市中心医院泌尿外科接受前列腺癌根治术后出现生化复发并接受治疗的132例患者,依据生化复发后采用治疗方案的不同,将其分为外放射治疗组(36例)、内分泌治疗组(45例)和联合治疗组(外放射治疗联合内分泌治疗,51例)。收集并比较三组临床资料,随访后比较三组生存期及不良反应发生情况。结果三组年龄、体重指数、术前前列腺特异性抗原(PSA)、Gleason评分、临床分期、PSA倍增时间比较,差异无统计学意义(P>0.05)。所有患者随访24~132个月,中位随访时间为63.5个月。外放射治疗组、内分泌治疗组和联合治疗组的无生化复发生存率为50.0%、51.1%和66.7%,中位生存期分别为62.0、67.9、78.1个月,联合治疗组的无生化复发生存率高于外放射治疗组和内分泌治疗组,差异有统计学意义(P<0.05)。三组潮热、尿道反应、肠道反应及性功能障碍发生率比较,差异无统计学意义(P>0.05)。结论对于前列腺癌根治术后出现生化复发的患者,外放射治疗联合内分泌治疗组在延长中位生存期方面更具优势,不良反应无明显差别,更能获得生存获益与治疗安全性之间的平衡。Objective To evaluate the effects of external radiotherapy combined with endocrine therapy on patients with biochemical recurrence after radical prostatectomy.Methods A total of 132 patients with biochemical recurrence after radical prostatic cancer surgery in Department of Urology,Xuzhou Central Hospital of Jiangsu Province from January 2010 to December 2018 were selected.According to the different treatment regimens after biochemical recurrence,the patients were divided into three groups:external radiotherapy group(36 cases),endocrine therapy group(45 cases),and combined treatment group(external radiotherapy combined with endocrine therapy,51 cases).The clinical data of the three groups were collected and compared,and the survival and adverse reactions of the three groups were compared after follow-up.Results There were no significant differences in age,body mass index,preoperative prostate specific antigen(PSA),Gleason score,clinical stage,and PSA doubling time among the three groups(P>0.05).All patients were followed up for 24 to 132 months,with a median follow-up of 63.5 months.Biochemical recurence-free survival rates were 50.0%,51.1%and 66.7%in the external radiotherapy group,the endocrine therapy group,and the combination treatment group,with median survival rates of 62.0,67.9,and 78.1 months,respectively.The biochemical recurence-free survival rates in the combination treatment group were higher than those in the external radiotherapy group and the endocrine therapy group,the difference was statistically significant(P<0.05).There were no significant differences in the incidence of hot flashes,urethral reactions,intestinal reactions,and sexual dysfunction among the three groups(P>0.05).Conclusion For patients with biochemical recurrence after radical prostatectomy,the combination of external radiotherapy and endocrine therapy group had more advantages in prolonging median survival time,and there was no significant difference in adverse reactions.Overall,the balance between survival benefit and treatment s
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