不同时间新辅助内分泌疗法对局部晚期前列腺癌疗效的影响

Effect of different time neoadjuvant hormornal therapy for locally advanced prostate cancer

目的 探讨局部晚期前列腺癌联合治疗中新辅助内分泌疗法（ NHT）的理想方案.方法 诊断明确的局部晚期（T3-4N0M0）前列腺癌患者60例,均采用NHT治疗方案.治疗前随机分为3组,每组20例,各组行不同时间NHT,A组：2周NHT,B组：3个月NHT,C组：6个月NHT.结果 A、B、C组患者NHT后前列腺特异抗原（PSA）中位值分别为24.88（ 6.62～55.86）、0.20（0.05～12.07）和0.07（ 0.01～2.01） ng/ml,与治疗前比较差异均有统计学意义（均P=0.00）,组间比较差异有统计学意义（均P=0.00）.A、B、C组行NHT后前列腺体积分别为（49.50±14.19）、（47.35±17.99）和（36.15±7.17）ml,B、C两组治疗前后前列腺体积比较差异有统计学意义（P=0.04、0.00）,治疗后A组与C组、B组与C组比较差异有统计学意义（P=0.00、0.01）.A、B和C组治疗后最大尿流率（Qmax）平均值分别为（ 8.75±2.15）、（11.70±2.81）和（14.45±2.61）ml/s,B组和C组治疗前后比较差异有统计学意义（均P=0.00）,治疗后各组间比较差异有统计学意义（均P=0.00）.结论 NHT治疗时间至少应达到3个月,能够达到降低PSA。

Objective To investigate ideal solution of neoadjuvant hormomal therapy （NHT） for locally advanced prostate cancer.Methods 60 patients diagnosed with locally advanced （T3-4N0M0） prostate cancer were treated with NHT.They were randomly divided into 3 groups of 20 cases.A group：NHT 2 weeks,B group：NHT 3 months,C group：NHT 6 months.Results The median PSA of A,B and C group after NHT were 24.88 （6.62-55.86）,0.20 （0.05-12.07） and 0.07 （0.01-2.01） ng/ml,respectively.There was statistically significance compared with those in untreatment （ all P =0.00）.There was statistically significant （P =0.00）among groups.The prostate volume of A,B and C group were （49.50＋14.19）,（47.35±17.99） and （36.15±7.17）ml,respectively.There was statistically significance in the B and C group compared with that in untreatment （P =0.04,0.00）.There was statistically significant between A and C group and between B and C group （P =0.00,0.01）.The Qmax of A,B and C group were （8.75±2.15）,（11.7±2.81） and （14.45±2.61） ml/s,respectively.There was statistically significance in the B and C group compared with untreatment （both P =0.00）.There was statistically significance among groups （all P =0.00）.Conclusion The NHT time should last at least 3 months in order to reduce PSA and prostate volume and to increase the Qmax