BT联合IHT与单纯IHT治疗T_3期前列腺癌的近期疗效比较

Comparison of the short-term effect of stage T_3 prostate cancer between brachytherapy combined with intermittent hormonal therapy and simple intermittent hormonal therapy

目的比较近距离放疗(BT)联合间歇性内分泌治疗(IHT)与单纯IHT治疗T3期前列腺癌的近期疗效。方法将80例T3期前列腺癌患者随机分为两组,BT联合IHT治疗38例(BT+IHT组),单纯IHT治疗42例(IHT组)。比较两组治疗前后血清前列腺特异性抗原(PSA)水平、前列腺体积(PV)、最大尿流率(Qmax)及国际前列腺症状评分(IPSS)变化,并比较两组并发症发生情况。结果与治疗前比较,BT+IHT、IHT组治疗后PV缩小、IPSS降低、Qmax升高、PSA下降(P均<0.05);治疗后12个月,BT+IHT组PV缩小、IPSS降低、Qmax升高、PSA下降均较IHT组明显(P均<0.05)。BT+IHT组放射性粒子植入引起轻至中度的尿路及直肠刺激症状10例、一过性血尿3例、急性尿潴留3例,对症处理后好转。两组内分泌治疗引起的并发症:BT+IHT组潮热14例、体力下降10例、轻度精神及神经系统症状3例,并发症总发生率71.1%(27/38);IHT组分别为16、15、4例及83.3%(35/42);两组比较,P均>0.05。结论 BT联合IHT对T3期前列腺癌的近期疗效明显优于单纯IHT;两组早期内分泌治疗引起的并发症无明显差异。

Objective To study and compare the short-term effects of the brachytherapy combined with intermittent hor- monal therapy and simple intermittent hormonal therapy of stage T3 prostate cancer. Methods A total of 80 cases with stage T3 prostate cancer were randomly divided into two groups： 38 cases of brachytherapy combined with intermittent hormonal therapy （ BT ＋ IHT group）, 42 cases of simple intermittent hormonal therapy （ IHT group）. The changes of PSA, IPSS, PV, Qm~ in the two groups were compared before and after treatment, and the early occurrence of complications of hormonal thera- py in the two groups was also compared. Results After treatment, the clinical effects in both BT ＋ IHT and II-IT groups were greatly improved, PV reduced, IPSS score declined, Qm^x was increased, and PSA was declining （ P 〈 0.05 ）. After twelve months of treatment, BT ＋ IHT group had more significant clinical effect in PV, IPSS, Q^x and PSA than IHT group （ P 〈 0.05）. In BT ＋ IHT group, 10 cases of light to moderate rectal and urinary irritation symptoms induced by radioactive seed implantation, 3 cases of transient hematuria, and 3 cases of acute urinary retention. All the syndromes were improved after the symptomatic treatment. The early complications of hormonal therapy between two groups （ BT ＋ IHT and II1T groups re- spectively） in hot flashes （14 vs. 16）, decreased strength （10 vs. 15）, mild mental and neurological symptoms （3 vs. 4） and incidence of complications （71.1% vs. 83.3% ） were not significantly different （P 〉 0.05 ）. Conclusion The recent effect of brachytherapy combined with intermittent hormonal therapy for the treatment of stage T3 prostate cancer is better than simple intermittent hormonal therapy, and the early hormonal therapy complications have no significant differences.