比卡鲁胺治疗激素抵抗性前列腺癌

Bicalutamide for hormone refractory-prostate cancer

目的观察比卡鲁胺(bicalutamide,康士得,casodex)治疗激素抵抗性前列腺癌(HRPC)的疗效。方法经睾丸切除加氟他胺或福至尔治疗后前列腺特异性抗原(PSA)再次升高,病变进展的前列腺癌患者28例,年龄52～82岁。Gleason评分2～4分4例,5～6分7例,7～10分17例。临床分期C期6例、D期22例。比卡鲁胺治疗,50mg或150mg每日1次口服,疗程3～25个月,观察治疗前后血清PSA及临床症状的变化。结果比卡鲁胺治疗后,18例患者PSA由治疗前(92.6±34.5)ng/ml降至(32.6±11.4)ng/ml,持续4～22个月,平均8.5个月。其中10例患者PSA(27.2±6.0)ng/ml,下降>50%,临床症状改善8例,前列腺结节较前缩小7例,骨转移有好转5例。结论比卡鲁胺作为二线激素治疗药物对于激素抵抗性前列腺癌有一定疗效。

Objective To evaluate the efficacy of bicalutamide (casodex) in the treatment of hormone-refractory prostate cancer. Methods Twenty-eight patients (52-82 years;Gleason score:2-4 in 4 cases,5-6 in 7 cases,7-10 in 17 cases;Whitmore Jewett clinical stage:6 cases of stage C and 22 cases of stage D) received oral bicalutamide,50 mg/d or 150 mg/d,as second-line therapy after disease progression and an increase in prostate specific antigen (PSA) following treatment with bilateral orchiectomy and flutamide.The bicalutamide treatment lasted 3-25 months.The changes in serum PSA levels and clinical symptoms were observed before and after treatment. Results Following treatment with bicalutamide,18 patients showed a decline in PSA levels,from (92.6±34.5) ng/ml to(32.6±11.4)ng/ml.The mean duration of improvement was 8.5 months (range,4-22 months).Of the 18 patients,10 had a 50% or greater decline in PSA level,which was decreased to(27.2±6.0)ng/ml.Clinical symptoms were improved in 8 patients, and the nodules of prostates became smaller in 7 patients.Bone metastasis was improved in 5 patients. Conclusions Bicalutamide (casodex) is effective as second-line hormonal therapy for some patients with hormone-refractory prostate cancer.