摘要
目的观察雌激素治疗激素难治性前列腺癌(HRPC)的临床效果及不良反应。方法收集北京大学泌尿外科研究所32例激素难治性前列腺癌患者资料,治疗经过每天口服己烯雌酚2mg,观察服药后血清前列腺特异抗原(PSA)变化,疾病进展时间,患者总体生存率、疾病特异生存率并观察药物毒副作用。结果29例前列腺癌患者资料完整,平均用药时间(8.6±0.9)个月,PSA反应(PSA降低〉50%)8例(27.5%),PSA稳定(PSA降低〈50%,或PSA增高〈25%)7例(24.1%);PSA进展(PSA增高〉25%)14例(48.3%)。总体中位疾病进展时间4个月(1—12个月)。PSA反应患者中位疾病进展时间6个月(5—12个月)。总体生存率为48.3%,疾病特异生存率为55.2%。主要不良反应为乳房胀痛硬结10例(34.5%);深静脉血栓3例(10.3%)。结论每天口服2mg己烯雌酚治疗激素难治性前列腺癌可使27.5%的患者PSA降低〉50%,24.1%患者PSA稳定,中位疾病进展时间4个月,雌激素治疗激素难治性前列腺癌效果肯定。
Objective To summarize the clinical outcome and adverse events of estrogen therapy for hormone refractory prostate cancer. Methods A total of 32 patients with hormone refractory prostate cancer received diethylstilbestrol (DES) 2 mg daily at our institute. The data of PSA (prostate-specific antigen) change, time to progression, overall survival rate, disease-specific survival rate and adverse events were collected and analyzed. Results The data of 29 patients were complete. The mean duration of DES dosing was 8. 6 ±0. 9 months. Among them, 8 (27.5%) patients achieved a PSA response with a 50% decrement of PSA or more. Seven (24. 1% ) patients had a stable level of PSA(50% 〈 PSA 〈 125% )while 14 of 29 (48.3%) maintained a PSA progression with a 25% increment of PSA or more. The overall median time to progression was 4 (1 -12) months. And the median time to progression was 6 (5 -12) months in the PSA response group. The overall survival rate was 48.3% and disease-specific survival rate 55.2%. The main adverse events were gyneeomastia ( 10/29, 34. 5% ) and deep vein thrombosis ( 3/29, 10. 3% ) . Conclusion When used for the treatment of hormone refractory prostate cancer, dethylstilbestrol at a daily dose of 2 mg can achieve a PSA response in 27. 5% patients and a PSA stability in 24. 1% patients. And the median time to progression is 4 months. Estrogen is efficacious for the patients with hormone refractory prostate cancer.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2011年第32期2247-2249,共3页
National Medical Journal of China
关键词
前列腺肿瘤
雌激素
己烯雌酚
Prostatic neoplasms
Estrogen
Diethylstilbestrol