冷冻消融术联合化疗对去势抵抗性前列腺癌的疗效及安全性研究  

Research on the efficacy and safety of cryoablation combined with chemotherapy in the treatment of castration-resistant prostate cancer

作　　者：郭善明 盛明雄 张家彬 万玲玲 GUO Shanming;SHENG Mingxiong;ZHANG Jiabin;WAN Lingling(Department of Urology,Mindong Hospital Affiliated to Fujian Medical University,Fujian,Fu'an 355000,China)

机构地区：[1]福建医科大学附属闽东医院泌尿外科,福建福安355000

出　　处：《中国医药科学》2022年第16期13-17,56,共6页China Medicine And Pharmacy

基　　金：福建省自然科学基金资助项目(2018J01216)。

摘　　要：目的探讨化疗联合冷冻消融术对去势抵抗性前列腺癌(CRPC)患者的疗效及安全性。方法收集福建医科大学附属闽东医院2011年6月至2015年7月收治的24例CRPC患者的临床资料,按不同的治疗方法将化疗联合冷冻消融术设为冷冻组(n=11),将单纯采用化疗设为对照组(n=13),比较分析两组的总生存期、前列腺特异性抗原(PSA)动力学、骨痛缓解率、化疗毒副反应及局部并发症。结果冷冻组最低PSA低于对照组、到达最低PSA时间短于对照组,PSA进展时间长于对照组,差异有统计学意义(P<0.05)。两组总生存期、骨痛缓解率及化疗毒副反应发生情况比较,差异无统计学意义(P>0.05)。冷冻组肉眼血尿、尿潴留、肾积水和侵犯直肠发生率均低于对照组,差异有统计学意义(P<0.05)。结论前列腺冷冻消融术可降低化疗患者的最低PSA,减少到达最低PSA时间,延缓PSA进展以及减少局部并发症,其疗效显著,安全性高。Objective To investigate the efficacy and safety of chemotherapy combined with cryoablation in the treatment of castration-resistant prostate cancer.Methods The clinical data of 24 patients with castrationresistant prostate cancer admitted to and treated in Mindong Hospital Affiliated to Fujian Medical University from June 2011 to July 2015 were collected.According to different treatment methods,they were divided into the freezing group(n=11,treated with chemotherapy combined with cryoablation)and the control group(n=13,treated with chemotherapy alone).The overall survival,prostate specific antigen(PSA)kinetics,relief rate of bone pain,chemotherapeutic toxic side effects and local complications of the two groups were compared and analyzed.Results The lowest PSA in the freezing group was lower than that in the control group,the time to reach the lowest PSA was shorter than that in the control group,and the time for PSA progression was longer than that in the control group,with statistically significant differences(P<0.05).There was no significant difference in the overall survival,relief rate of bone pain and chemotherapeutic toxic side effects(P>0.05).The incidence of gross hematuria,urinary retention,hydronephrosis and invasion of the rectum in the freezing group were lower than those in the control group,with statistically significant differences(P<0.05).Conclusion Cryoablation of prostate can reduce the PSA nadir of chemotherapy patients,decrease the time to PSA nadir level,delay PSA progression,and lessen local complications.Therefore,it has obvious therapeutic efficacy and high safety.

关 键 词：前列腺癌 冷冻消融术 化疗 多西他赛 

分 类 号：R737.25[医药卫生—肿瘤]