间歇性与持续性雄激素阻断治疗晚期前列腺癌的疗效比较

Comparative analysis of efficacy between intermittent and continuous androgen deprivation therapy for advanced prostate cancer

目的比较间歇性和持续性雄激素阻断治疗晚期前列腺癌患者的疗效。方法选取69例晚期前列腺癌患者,按照治疗方法,分为间歇性联合雄激素阻断治疗组(A组,34例)和持续性雄激素阻断治疗组(B组,35例),分析两组患者疾病进展时间和不良反应发生情况。结果 A组患者中位疾病进展时间为31个月,B组为28个月,两组之间的差异无统计学意义(P>0.05)。A组和B组有骨转移的患者的中位疾病进展时间分别为24个月和18个月,两组之间的差异有统计学意义(P<0.05)。A组和B组无骨转移患者的中位疾病进展时间分别为39个月和42个月,两组之间的差异无统计学意义(P>0.05)。A组患者潮热症发生率为20.6%,骨质疏松发生率为11.8%,腹泻发生率为5.9%,各不良反应发生率与B组患者相比,差异均有统计学意义(P<0.05)。结论对晚期前列腺癌患者采用间歇性联合雄激素阻断治疗,有可能延迟骨转移前列腺癌患者的疾病进展,能够显著降低不良反应发生率,具有临床指导意义。

Objective Comparative analysis of efficacy between intermittent and continuous andro- gen deprivation （ADT） therapy for advanced prostate cancer （APC）. Methods Sixty-nine patients with APC were divided into intermittent combined ADT group （A） and continuous ADT group （B）. Time to pro- gression and situation of adverse reactions between group A and group B was compared. Results Median time to progression of group A and group B was 31 months and 28 months, respectively, （P 〉 0.05）. In patients with bone metastasis （BM）, the median time to progression of group A and group B was 24 and 18 months, respectively （P 〈 0. 05）. The median time to progression of patients without BM in group A and group B was 39 months and 42 months, respectively （P 〉 0. 05）. The incidence of hot flashes symptoms, osteoporosis and diarrhea in group was 20. 6 %, 11.8 % and 5. 9%, respectively. The differences in all above mentioned adverse reactions between group A and group B were statistically significant （P 〈 0. 05 ）. Conclusions Intermittent combined ADT could delayed disease progression in prostate cancer patients with BM, could significantly reduce the incidence of adverse reactions, and is significance in guiding treatment of APC.