前列腺癌患者 LH-RH 缓释剂治疗后性激素及肿瘤标记物水平变化

Long acting LH RH analogue for the treatment of prostatic cancer

对３２例采用ＬＨＲＨ缓释剂治疗的前列腺癌患者进行性激素水平及肿瘤标记物状态的对比研究，１６例为初诊经组织病理学诊断及治疗后获得可评价性资料病例。６例患者在ＬＨＲＨ缓释剂初次治疗后血浆睾酮一过性升高，５例３日达高峰，１例持续近１４日；５例患者出现一过性症状加重，２例表现为骨痛加重，３例排尿困难加重。Ｄ期患者的生存时间较切睾组长７～１４个月。１４例患者治疗前检查了前列腺特异抗原（ＰＳＡ），治疗后６例睾酮升高患者中４例同时ＰＳＡ出现轻微升高，ＰＳＡ对前列腺癌的诊断及预后判断均有重要意义。认为ＬＨＲＨ缓释剂与抗雄激素联合治疗可提高其安全性，减少在初次治疗后的一过性加重反应，相对延长生存时间。

After the administration of a long acting luteinizing hormonal releasing hormone (LH RH)analogue in 16 patients with histopathologically identified prostatic cancer,the hormonal levels and tumor markers were evaluated.The surge in plasma testosterone was detected in 6 patients after the first administration of a long acting LH RH analigue and reached the highest level after the third day in 5 and the 14th day in 1.Flare up reaction due to a transient increase in plasma testosterone was observed in 5 patients,with bone pain in 2 and acute urine retention in 3.Prostatic specific antigen has been assayed before treatment in 14 and in 6 patients with elevated testosterone after the treatment the PSA was also elevated in 4.In D stage prostatic cancer,the survival time has been 7 14 months longer with the combined use an antiandrogen and long acting LH RH analogue than those with simple orchiectomy.It was suggested that the combined use of antiandrogen and long acting LH RH analogue is safe and helps prevent the risk of a flare up reaction.