二代抗雄新辅助治疗局部晚期前列腺癌1例报告  

The second-generation of antiandrogen drugs as neoadjuvant therapy for locally advanced prostate cancer patient:a case report

作　　者：赵德龙 郭安东 曹吉双 吴晨睿 丁森泰 Zhao Delong;Guo Andong;Cao Jishuang;Wu Chenrui;Ding Sentai(Department of Urology,Shandong Provincial Hospital Afiliated to Shandong First Medical University,Jinan,Shandong 250000,China;Department of Urology,Shandong Provincial Hospital Affiliated to Shandong University,Jinan,Shandong 250000,China)

机构地区：[1]山东第一医科大学附属省立医院泌尿外科,山东济南250000 [2]山东大学附属省立医院泌尿外科,山东济南250000

出　　处：《泌尿外科杂志（电子版）》2024年第2期101-106,共6页Journal of Urology for Clinicians(Electronic Version)

摘　　要：以往局部晚期前列腺癌(locally advanced prostate cancer,LAPC)治疗经验为传统内分泌治疗,随着恩杂鲁胺等新型内分泌药物的问世,现阶段临床先给予LAPC患者新辅助治疗,再采用前列腺根治性切除术,这一方式成为新的治疗方案。本文报告1例采用恩杂鲁胺联合雄激素剥夺治疗(androgen deprivation therapy,ADT)行新辅助内分泌治疗(neoadjuvant hormonal therapy,NHT)的病例。患者男,61岁,因体检发现前列腺特异性抗原(prostate specific antigen,PSA)升高2 d入院,PSA为1960 ng/ml。磁共振成像示前列腺病灶累及双侧精囊腺,邻近膀胱壁受累,伴有盆腔多发淋巴结转移。穿刺确诊为前列腺癌(prostate cancer,PCa),前列腺癌格利森评分4+4=8分,分期为T4N1M0。患者采用恩杂鲁胺联合戈舍瑞林3个月后,行前列腺特异性膜抗原(prostate specific membrane antigen,PSMA)正电子发射计算机断层显像(positron emission computed tomography,PET-CT)示,在PCa内分泌治疗中,前列腺病灶累及左侧精囊腺,PSMA高表达,两侧髂血管旁多发淋巴结转移,右侧髂总血管旁淋巴结PSMA高表达,未见远处转移。后行根治性前列腺切除术。恩杂鲁胺联合ADT作为NHT,为患者赢得了手术条件。In the past,the traditional therapies for locally advanced prostate cancer(LAPC)were endocrine drugs,but with the advent of novel endocrine drugs,such as enzalutamide,neoadjuvant therapy for LAPC patients and followed by radical prostatectomy,is becoming a new therapeutic schedule.A case of neoadjuvant endocrine therapy(NHT)with enzalutamide combined with androgen deprivation therapy(ADT)was reported.A 61-years old male patient was admitted to hospital due to prostate specific antigen(PSA)elevation for 2 days after physical examination,and the blood PSA was 1960 ng/ml.Pr-ostate magnetic resonance imaging suggested that the prostate lesions invaded the bilateral seminal vesicle glands,combined with multiple pelvic lymph node metastases,and the bladder wall was invaded,too.Prostate cancer(PCa)was diagnosed bypuncture.Gleasons core was 4+4=8,and stage was T_4N_1M_0.The patient was treated with Gosselin combined with Enzalutamide for 3 months,and then prostate specific membrane antigen(PSMA)positron emission computed tomography(PET-CT)suggested,PCa were involvingin the endocrine therapy,the prostate lesions invaded the left seminal vesicle gland,with high expression of PSMA.There were multiple lymph node metastases on both sides of the iliac vessels,and the lymph nodes near the common iliac vessels on the right side has high expression of PSMA,without distant metastasis.Radical prostatectomy was performed.Enzalutamide combined with ADT as NHT won the patient the condition for surgery.

关 键 词：局部晚期前列腺癌 恩杂鲁胺 前列腺切除术 新辅助治疗 

分 类 号：R737.25[医药卫生—肿瘤]