康士德治疗晚期前列腺癌临床分析

Effects of casodex on advanced prostate cancer

目的探讨康士德在晚期前列腺癌治疗中的疗效。方法晚期前列腺癌患者64例分为2组，其中康士德联合去势治疗46例为治疗组，单纯手术去势治疗18例为对照组，比较2组临床症状、血清前列腺特异性抗原（PSA）值、前列腺大小、肿瘤体积、生化复发时间以及病死率等。结果治疗组患者临床症状缓解率为82．6％，对照组为72．2％，2组比较有统计学意义；治疗组有34例（73．9％）的患者PSA下降到4.0ng/ml以下，而对照组只有5例（27．8％），2组比较有统计学意义；2组前列腺体积均下降，但组间比较无统计学意义；治疗组生化复发时间平均为22．6个月，生化复发率为34．8％，客观进展率为39．1％，而对照组生化复发时间平均为12．4个月，生化复发率为55．6％；客观进展率为50.0％，2组比较有统计学意义。结论康士德能明显减轻患者的临床症状及局部体征，是治疗晚期前列腺癌安全有效的药物。

Objective To observe the theraputie effects of Casodex on advanced prostate cancer and side effects of the therapy. Methods Totally 64 patients were reviewed, based on 2 groups, control group had 46 patients treated by castration combined with surgery castration, or Luteinizing Hormone Releasing Hormone Ethylamidum （LHRH） medicine and casodex, treatment group had 18 patients treated only by surgical castration. Relevant symptoms ; quality of life, prostate specific antigen level, risk of illness progressing, survival rate and side effects of medicines for the two groups were analyzed. Results The remission rates were 82.6% （control group） and 72.2% （treatment group） respectively, showing a statistical difference （P 〈0. 05）. In control group, 34 patients＇ prostate specific antigen level reduced to less than 4.0 ng/ml, while the treatment group only had 5 patients under the same leveL As for the reduction of prostate volume, there was no significant difference between the two groups. There was a significant defference of the biochemical index based recurrence rate between control group （34.8%） and treatment group （55.6%）. The mean duration of plateau stage before recurrence was 22. 6 months in control group, longer than 12.4 months in treatment group （P 〈0. 05）. The progressive rate of the two groups was 39.1% and 50% respectively, with a significant difference. Conclusion As a safe and effective medicine, Casodex could reduce the patients＇ clinical symptoms with minor side effects.