全雄激素阻断与全雄激素阻断结合^(125)Ⅰ放射性粒子植入治疗中晚期前列腺癌的疗效比较

Comparison of total androgen blockade and total androgen blockade combined with ^(125)Ⅰ brachytherapy in middle and later period prostate cancer

目的:比较全雄激素阻断(双侧睾丸切除+抗雄激素药物)与全雄激素阻断结合125Ⅰ放射性粒子植入治疗中晚期前列腺癌的临床疗效,探讨治疗中晚期前列腺癌的有效方法。方法:中晚期前列腺癌患者40例,其中12例应用全雄激素阻断治疗(A组),28例应用全雄激素阻断结合125Ⅰ放射性粒子植入近距离放射治疗(B组)。比较治疗前后前列腺特异性抗原的变化及术后3年生存率。结果:术后1个月2组前列腺特异性抗原均快速下降,2组比较差异无统计学意义(P>0.05);术后6个月,B组前列腺特异性抗原明显低于A组,差异有统计学意义(P<0.05);2组术后3年生存率差异有统计学意义(P<0.05)。结论:全雄激素阻断治疗及全雄激素阻断结合125Ⅰ放射微粒植入近距离放射治疗,均是治疗中晚期前列腺癌的有效方法,而后者疗效更加肯定。

Objective To investigate the therapeutic efficacy of total androgen blockade （bilateral orchidectomy and anti androgen drugs ） and total androgen blockade combined with ^125I brachytherapy in middle and later period prostate cancer. Methods Forty patients with prostate cancer in recent 5 years were analyzed retrospectively. Twelve of them were treated with total androgen blockade （group A）, and 28 treated with total androgen blockade combined with ^125I brachytherapy （group B）. The 3-year survival rate and the changes of serum prostate-specific antigen levels between pre- and post-treatment were compared. Results The level of prostate-specific antigen decreased rapidly both in group A and in group B one month after operation. But there was no statistic difference between the two groups（P〉0.05）. However, the level of prostate-specific antigen 6 months after operation in group A was quite different from that in group B （P〈0.05）. The difference of 3-year survival rate between the two groups had a statistic difference（P〈0.05）. Conclusion Total androgen blockade and total androgen blockade combined with ^125I brachytherapy are both effective for patients with middle period and advanced prostate cancer, and the latter one is more effective.