氟他胺联合双膦酸盐治疗前列腺癌骨转移性疼痛的临床观察

Palliative treatment of bone pain related to prostatic cancer metastasis with Flutamide combined Bisphosphonates

目的:探讨氟他胺联合双膦酸盐类药物对晚期前列腺癌骨转移疼痛的治疗价值。方法:回顾分析19例明确诊断前列腺癌并骨转移的晚期前列腺癌患者临床资料。所有病例均施行去势术并抗雄激素治疗,在继续服用抗雄激素药物的同时,辅以双膦酸盐治疗。本组病例在行双侧睾丸切除术后第5天开始口服氟他胺,用药期间不再使用抗癌药物及其他内分泌治疗。当患者出现骨转移性疼痛时即开始服用双膦酸盐。结果:本组所有病例于治疗后骨转移病灶均有不同程度缩小,治疗后6个月转移病灶数减少了65.7%,12个月减少了46.4%。治疗后3个月骨转移病灶疼痛缓解率为78.9%,6个月为83.5%,12个月为65.9%。治疗后血清PSA明显下降。结论:氟他胺联合双膦酸盐类药物是缓解晚期前列腺癌骨痛的有效手段,能减轻肿瘤患者的痛苦,提高肿瘤患者的生存质量。

Objective：To investigate the role of flutamide combined bisphosphates in the treatment of advanced prostates cancer patients complaining of bone pain due to metastasis. Methods ： The clinical data of 19 cases of prostatic cancer with multiple skeletal complications were analyzed retrospectively. The flutamide was taken in by the patients at 5th day after receiving bilateral orehidectomy and other anticancer drugs or endocrine therapies were refused during the period of overdose. While the bispbosphates was taken in by the patients in case of bone pain due to metastasis occurred. Results： The osseous metastatic lesions areas were diminished differently and the lesions were decreased 65.7% after 6 months ,65.9% afterl2 months. The odynolysis rates were 78.9%, 83.5% and 65.9% after 3 months, 6 months and 12 months respectively. The serum PSA level was also declined obviously. Conelusions：Flutamide combined bispbosphates are promising weapons for the management of advanced prostatic cancer related bone pain. It can relieve the patient＇s bone pain significantly and improve the survival quality.