前列腺癌药物去势后早期血清激素变化与生活质量评估

Assessment of serum hormones and survey on quality of life in prostate cancer patients after androgen deprivation therapy

目的探讨内分泌治疗对前列腺癌患者生活质量的影响。方法42例失去手术指征的进展期前列腺癌患者，每28天皮下注射诺雷德（3．6mg）1次，分时段测定血清睾酮及前列腺特异抗原（PSA），并对相关生活质量进行调查。结果治疗3周后可达去势水平[血清睾酮由（568．15±198．25）μg/L到（17．46±3、81）μg/L]；治疗1月后血清PSA明显下降[由（92．14±29．43）μg/L降至（20．26±4．31）μg/L]，前列腺体积缩小，梗阻症状改善，但疼痛、因病所致日常活动受限等情况均无显著变化。精神疲软、乏力和食欲不振等较用药前显著加重；全身健康情况、性功能较前显著减退。结论药物去势可在短期内明显降低前列腺癌患者血清睾酮和PSA水平，减轻排尿困难症状；但对健康相关的生活质量有明显的影响。

Objective To investigate the effects of medicine androgen deprivation therapy（ADT） on quality of life in patients with prostate cancer. Methods A total of 42 consecutive advanced prostate cancer patients without any other anti-androgen medications after ADT [ A subcutaneous depot injection of LHRH-agonist （Zoladex） was instituted every 28 days] were enrolled. Levels of serum testosterone and prostatic specific antigen （PSA ） were obtained just prior to ADT and after ADT. The general and disease-specific health-related quality of life were assessed. Results The average testosterone level was less than 50 mg/L after medical ADT in 3 weeks. And PSA level declined dramatically in one month. Although there were no significant differences on physical discomfort and limitations to daily activities. Urinary obstruction symptoms after ADT were disappeared and the size of prostate were reduced after one month. The appetite and vigor were worsened. Overall health status and sexual function were significantly reduced. Conclusion The ADT could make serum testosterone and PSA decline dramatically in short time, and worsen some general health-related quality of life.