内分泌治疗联合外放射治疗局部晚期前列腺癌疗效分析

Efficacy of Endocrine Therapy Combined with Radiotherapy for Locally Advanced Prostate Cancer

目的探讨内分泌治疗联合外放射治疗局部晚期前列腺癌的疗效及安全性。方法选取2008年6月—2011年6月我院的局部晚期前列腺癌患者20例进行内分泌治疗(最大限度雄激素阻断)联合外放射治疗(调强适形外放射治疗),另选取同期局部晚期晚期前列腺癌患者16例采取单纯内分泌(最大限度雄激素阻断)治疗,随访9～40个月,分析比较两组患者的临床症状缓解率、前列腺体积、血清前列腺特异性抗原(PSA)值、肿瘤控制率、不良反应发生率及生存率等方面。结果治疗3个月后联合治疗组临床症状缓解率与单纯治疗组比较,差异有统计学意义(χ2=4.130,P=0.042);两组治疗前后前列腺体积的差值比较,差异有统计学意义(t=4.331,P=0.000);治疗后两组血清PSA<0.2μg/L者所占比例比较,差异有统计学意义(χ2=4.410,P=0.036);两组疾病控制率比较,差异有统计学意义(χ2=5.132,P=0.023);两组不良反应发生率比较,差异无统计学意义(χ2=2.756,P=0.097);联合治疗组及单纯治疗组在随访期间均无1例肿瘤特异性死亡。结论内分泌治疗联合外放射治疗可明显改善局部晚期前列腺癌患者的临床症状、降低血清PSA水平、提高疾病控制率及生存率,且无明显不良反应,疗效优于单纯内分泌治疗,是一种安全、有效的治疗措施。

Objective To investigate the efficacy and safety of endocrine therapy combined with radiotherapy for locally advanced prostate cancer.Methods 20 patients with locally advanced prostate cancer admitted to our hospital from June 2008 to June 2011 were treated with endocrine therapy（maximum androgen blockade） combined with radiotherapy（intensity-modulated conformal radiotherapy）.Another 16 patients of the same period with locally advanced prostate cancer were only treated with endocrine therapy（maximum androgen blockade）.All the patients were followed up for nine to 40 months.Clinical remission rate,prostate volume,serum PSA,tumor control rate,adverse events incidence and survival rate of the two groups were analyzed and compared.Results After three months treatment,the clinical remission rate of combined treatment group showed statistically significant difference compared with that of the simple endocrine treatment group（χ^24.130,P=0.042）.The prostate volume of the two groups showed statistically significant difference respectively before and after treatment（t=4.331,P=0.000）.The proportion of serum PSA0.2 μg/L of the two groups after treatment showed statistically significant difference（χ^24.410,P=0.036）.The tumor control rate of the two groups showed statistically significant difference（χ^25.132,P=0.023）.The adverse events incidence of the two groups showed no statistically significant difference（χ^22.756,P=0.097）.No tumor-specific death was found during the following up in both the combined treatment group and simple endocrine treatment group.Conclusion Endocrine therapy combined with radiotherapy can effectively improve clinical symptoms of patients with locally advanced prostate cancer,and it can also reduce serum PSA level,improve tumor control rate and survival rate without adverse events.The combined treatment is safe and effective with better efficacy than simple endocrine treatment.