89例中晚期前列腺癌内分泌治疗临床分析

Clinical analysis on endocrine therapy of 89 cases of late prostate carcinoma

目的探讨内分泌治疗中晚期前列腺癌的临床疗效以及前列腺特异性抗原(PSA)在临床诊疗中的价值。方法对内分泌治疗的中晚期前列腺癌患者进行随访,并结合临床资料进行分析。结果共随访89例中晚期前列腺癌患者,其中死亡20例,获取完整随访资料者72例,97%患者临床症状得到改善,血清PSA下降[治疗前(106.32±197.66)ng/ml与治疗后3个月(22.35±126.32)ng/ml(t=3.67,P<0.01);治疗前与治疗后6个月(36.29±173.00)ng/ml(t=3.50,P<0.01);治疗后3个月与治疗后6个月(t=-0.782,P>0.05)]。结论内分泌治疗可明显控制前列腺癌疾病进展,改善尿路梗阻等症状;PSA在前列腺癌的早期诊断、临床分期、疗效监测及预后判定中可发挥重要作用,对于伴有下尿路梗阻的患者,是否结合经尿道前列腺电切术(TURP)进行治疗,仍然需要进一步探讨。

Objective To explore the clinical efficacy of endocrine therapy in treatment of patients with late prostate carcinoma and the value of PSA in clinical diagnosis and treatment. Methods Eighty-nine patients with late prostate carcinoma who underwent endocrine therapy were followed up and analyzed according to clinical data. Results Eighty-nine cases were followed up, 20 of them died ,72 of them had complete clinical data. 97% patients had clinical symptoms improved, PSA decreased [ （ 106. 32 ± 197.66） ng,/ml before the treatment vs. （22. 35± 126. 32）ng/ml 3 months after treatment（ t = 3.67, P 〈0. 01 ） ; before the treatment vs. 6months after treatment （36. 29 ± 173. 00） ng,/ml （ t = 3.50, P 〈 0. 01 ） ; 3 months after treatment vs. 6months after treatment（t = - 0. 782, P 〉 0. 05） ]. Conclusion Endocrine therapy is an important method in the treatment of prostate carcinoma, and can control the disease and improve clinical symptom. PSA plays a role in early diagnosis, division of clinical stage, efficacy monitoring, and prognostic judgement of prostate carcinoma. But there are still debates about treatment of lower urinary tract obstruction with endocrine therapy combined with TURP.