晚期前列腺癌的雄激素阻断治疗.docVIP

晚期前列腺癌的雄激素阻断治疗 　　作者：王惠君　　作者单位：北京，中国医学科学院北京协和医院泌尿外科 　　【摘要】 探讨间歇性雄激素阻断治疗与持续性雄激素阻断治疗晚期前列腺癌的疗效和不良反应。方法 65例晚期前列腺癌患者分为两组，A组34例行间歇性雄激素阻断(IAB)治疗，B组31例行持续性雄激素阻断(CAB)治疗，比较两组在疾病进展时间和不良反应方面的差异。结果 A组中位随访时间为37.0个月，B组中位随访时间为35.8个月。A、B组疾病进展率分别为29.4%和54.8%，两组比较差异有统计学意义(P=0.038)。A、B组疾病中位进展时间分别为34.9个月、28.4个月，两组比较差异有统计学意义(P=0.0018)。在有骨转移患者中，A、B组疾病中位进展时间分别为33.6个月、27.1个月，两组比较差异有统计学意义(P=0.020)。在无骨转移患者中，A、B组疾病中位进展时间分别为38.7个月、30.3个月，两组比较差异有统计学意义(P=0.0006)。不良反应发生率分别为A组发生潮热症状23.5%、乳腺肿痛17.6%、骨质疏松14.7%。B组发生潮热症状64.5%、乳腺肿痛54.8%、骨质疏松45.2%。两组比较差异有统计学意义：潮热症状P=0.0006，乳腺肿痛P=0.0014，骨质疏松P=0.0065。结论 对晚期前列腺癌患者IAB治疗可以延缓病变的进展，减少雄激素阻断导致的不良反应，提高患者的生活质量，应作为晚期前列腺癌患者的首选治疗。 　　【关键词】 前列腺肿瘤，雄激素阻断，不良反应 　　Androgen blockade in treatment of late prostate cancer 　　WANG Hui-jun，JI Zhi-gang，YAN Wei-gang，et al.Department of Urology，Peking Union Medical College Hospital，Chinese Academy of Medical Sciences，Beijing 100730，China 　　[Abstract] Objective To compare the efficacy of intermittent androgen blockade ( IAB ) versus total continuous androgen blockade( CAB ) in the treatment of late prostate cancer.Methods The study included 65 patients with late prostate cancer.34 patients ( group A ) received IAB，and 31 patients ( group B ) received CAB.The time to disease progression and side effect rates was compared between the 2 groups.Results The median follow-up was 37.0 months in group A and 35.8 months in group B.The disease progression rate was 29.4% in group A and 54.8% in group B，with significant difference between the 2 groups (P=0.038).The median time to disease progression was 34.9 months in group A and 28.4 months in group B，there was significant difference between the 2 groups (P=0.0018 ).In patients with skeletal metastasis，the median time to disease progression was 33.6 months in group A and 27.1 months in group B，with significant difference between the 2 groups (P=0.020 ).In patients without skeletal metastasis，the median time to disease progression was 38.7 months in group A and 30.3 months in