诺雷德联合康士得间歇性治疗晚期前列腺癌的临床研究

Clinical Study of Intermittent Therapy with Zoladex and Casodex in the Treatment of Late-Stage Prostate Cancer

目的探讨局限性晚期前列腺癌间歇性内分泌治疗的效果。方法选取局限性晚期(T3a、T3b)前列腺癌患者60例,全雄性激素阻断治疗6～9个月,停药时机为前列腺特异性抗原(PSA)≤0.2ng/ml后,持续3～6个月,以后根据每月PSA的检测结果决定是否再行内分泌治疗。治疗期及间歇期检测血清睾酮值,并行B超检测前列腺体积。结果全部患者完成第1个周期的治疗,50例(83.33%)完成2个周期的治疗,22例(36.67%)完成3个周期的治疗,2例(3.33%)进入到第4个周期的治疗。第一至第四疗程的平均间歇期分别为5.32、5.53、5.36、2.17个月。治疗后6个月和12个月,前列腺体积较治疗前明显缩小(P<0.01),PSA水平较治疗前明显降低(P<0.01)。结论间歇性内分泌治疗是治疗局限性晚期前列腺癌的有效手段。总体安全性和耐受性良好,其近期治疗效果较好。

Objective To investigate the efficacy of the intermittent hormonal therapy （IHT） with Zoladex and Casodex in the treatment of late-stage prostate cancer.Methods IHT was employed to 60 patients with late-stage prostate cancer with the clinical staging of T3a or T3b.Specifically, maximal androgen blockade （MAB） therapies was employed for 6 to 9 months, and then stopped until the serum prostate specific antigen （PSA） was decreased to 0.2 ng/ml, which were lasting for 3 to 6 months.Subsequent MAB therapy was given according to the level of PSA.Serum testosterone level and volume of prostate were evaluated periodically.Results 83.33% of patients had completed 2 cycles of IHT, 36.67% had completed 3 cycles, 3.33% had came into the fourth cycle.The average interval time for the 1st to 4th course of treatment was 5.32, 5.53, 5.36 and 2.17 months, respectively.After 6 to 12 months of treatment, the volume of prostate was significantly reduced （P0.01）, and the levels of PSA was also decreased （P0.01）.Conclusion IHT is an effective approach for the treatment of local late-stage prostate cancer.Non-steroidal antiandrogen monotherapy is an attractive and effective method.