局限性前列腺癌调强适形放疗联合间歇性内分泌治疗的疗效评价

The therapeutic evaluation of intensity modulated radiation therapy combined with intermittent hormonal therapy for localized prostate cancer

目的探讨调强适形放射治疗（intensity modulated radiation therapy，IMRT）联合间歇性内分泌治疗（intermittent hormonal therapy，IHT）方法治疗局限性前列腺癌的疗效评价。方法将72例同期局限性前列腺癌患者随机分为两组，分别进行调强适形放射治疗联合间歇性内分泌治疗（37例）和单纯调强适形放射治疗（35例），分析比较两组患者的临床症状缓解率、前列腺体积变化、血清前列腺特异性抗原（PSA）值改变、肿瘤控制率、放疗不良反应发生率及生存率。结果随访5～118个月，平均56个月，联合治疗组与单纯治疗组比较，临床症状缓解率、前列腺体积差值、血清PSA〈0．2μg/L者所占比例及治疗后1年、3年、5年和8年的PSA无进展生存率差异均有统计学意义（P〈0．05）；治疗后1年、3年两组均无死亡病例，差异无统计学意义，治疗后5年、8年的生存率和早期放疗不良反应发生率两组间差异均有统计学意义（P〈0．05）。结论调强适形放射治疗联合间歇性内分泌治疗方法治疗局限性前列腺癌可明显缓解患者的临床症状，降低血清PSA水平，提高疾病控制率及生存率，降低放疗早期不良反应发生率，疗效优于单纯调强适形放射治疗，是一种安全、有效的治疗措施。

Objective To investigate the clinical therapeutic effect of intensity modulated radiation therapy （IMRT） combined with intermittent hormonal therapy （IHT） for localized prostate cancer. Method 72 patients with localized prostate cancer of same stage were randomized into two groups, receiving IMRT ＋ IHT （ 37 cases） or simple IMRT （35 cases） , and the clinical response rate, prostate volume, serum PSA, tumor control rate, adverse events incidence and survival rate of the two groups were compared. Result All patients were followed up for 5 to 118 months and mean time was 56 months. The clinical response rate, difference of prostate volume, proportion of patients with serum PSA〈0. 2 txg/ L, and the PSA-free survival rate in 1, 3, 5, and 8 years after treatment showed statistically significant difference between the two groups （ P〈0. 05） ; There was no death in 1 and 3 years after treatment in both groups, which was not statistically different, while the survival rate of the two groups in 5 and 8 years post treatment showed statistically significant difference （P〈0. 05）. Conclusion IMRT ＋ IHT effectively relieve clinical symptoms of patients, and lower serum PSA level, improve tumor control rate and survival rate as well as reduce adverse events, which is a safe and effective remedy with better therapeutic effect than simple IMRT.