非那雄胺在晚期前列腺癌治疗中的作用

The Function of Finasteride on Patients with Advanced Prostate Cancer

目的:探讨非那雄胺加间歇性雄激素阻断在晚期前列腺癌治疗中的作用。方法:将33例T_3期或T_4期前列腺癌患者分为两组,A组18例采用比卡鲁胺加戈舍瑞林,间歇性雄激素阻断治疗;B组15例采用非那雄胺加比卡鲁胺加戈舍瑞林治疗。间歇期内B组继续服用非那雄胺。结果:治疗后9个月,A组13例完全缓解,3例部分缓解,2例无变化,有效率为88.9%。前列腺特异性抗原(PSA)为0.3～37.3 ng/ml,平均(7.6±6.5)ng/ml。B组12例完全缓解,2例部分缓解,1例无变化,有效率为93.3%。PSA为0.1～10.5 ng/ml,平均(4.2±2.8)ng/ml。B组PSA值低于A组,差异有统计学意义(P<0.05)。随访61.7(31～82)个月,B组停药间期(25.1±10.1)个月长于A组(15.7±8.6)个月(P<0.05)。A组5年生存率为55.6%(10/18),B组为66.7%(10/15),差异无统计学意义(P>0.05)。治疗后5年,A组仍有6例有效(33.3%),B组8例有效(53.3%),差异无统计学意义(P>0.05)。结论:非那雄胺加上间歇性雄激素阻断治疗,能使晚期前列腺癌PSA进一步降低,停药间期延长。

Objective：To observe the effect of finasteride plus intermittent androgen blockade （IAB） on pa tients with advanced prostate cancer. Methods：A total of 33 patients with T3 T4 prostate cancer were observed. 18 patients（group A） were treated with IAB（bicalutamide and Goserelin）. 15 patients（ group B） were treated with IAB plus finasteride. In the time off treatment, patients in group B were treated with finasteride continuously. Resuits：9 months latter, 13 cases obtained complete remission, 3 cases obtained partial remission, 2 cases no change in group A. 12 cases＇obtained complete remission, 2 cases obtained partial remission, 1 case no change in group B. The serum prostate specific antigen （PSA） level was higher significantly in group A （0.3 37.3 ng/ml, average 7.6±6.5 ng/ml） than that in group B（0. 1-10.5 ng/ml, average 4.2±218 ng/ml ）（P〈0.05） . 33 cases were followed up from 31 to82 months（average 61.7 months）. The time off treatment was longer significantly in group B （25. 1±10.1 months） than that in group A（15.7±8.6 months） （P〈0.05）. 5 year survival rate of group A was 55 . 6% （10/18）, Bgroup was 66 . 7% （10/15）. The difference was not statistically significant （ P 〉 0. 05）. 6 cases still maintained effective in group A（33.3%） and 8 cases in group B（53.3%） 5 years latter after treatment（P〉0.05）. Conclusions：Compared with lAB monotherapy, the treatment of IAB plus finasteride can de crease serum PSA level obviously, extend time off treatment.