多西他赛联合泼尼松治疗激素难治性前列腺癌的临床效果观察

The clinical effect of docetaxel joint prednisone for hormone refractory prostate cancer

目的：探究多西他赛联合泼尼松治疗激素难治性前列腺癌（HRPC）的临床效果。方法：选取从2013年2月至2015年2月在我院接受治疗的HRPC患者72例。对患者在治疗前与治疗后的血清前列腺特异抗原（PSA）、骨痛NRS评分变化进行对比分析,并且对治疗后产生的毒副反应进行评价。结果：在所有参与研究的患者中,有4例（5.6%）失访,8例（11.1%）退出治疗。在可进行疗效评价的60例患者中,PSA至正常水平有16例（26.7%）;有效24例（40.0%）;稳定12例（20.0%）;无效8例（13.3%）。骨痛NRS评分降低28例（77.8%）;骨痛NRS评分无改变4例（11.1%）;骨痛NRS评分升高4例（11.1%）。在治疗后68例患者产生了毒副作用,骨髓抑制（Ⅰ~Ⅱ级）20例（29.4%）;骨髓抑制（Ⅲ~Ⅳ级）12例（17.6%）;静脉炎12例（17.6%）;口腔炎8例（11.8%）;脱发36例（52.9%）;轻度乏力16例（23.5%）;甲床改变20例（29.4%）;胃肠道反应24例（35.3%）。结论：在治疗激素难治性前列腺癌时,采用多西他赛联合泼尼松的方法效果良好,毒副作用小,应在临床中推广使用。

Objectives： To study the clinical effect of docetaxel joint prednisone for hormone refractory pros- tate cancer （HRPC）. Methods： 72 HRPC patients treated in our hospital from February 2013 to February 2015 were selected. The serum prostate specific antigen （PSA） and bone pain scores of NRS of patients before treatment and after treatment were compared, and the toxic and side effects generated after treatment were evaluated. Results： Of all the 72 patients participated in the study, there were 4 cases （5.6%） loss to follow - up, 8 patients （ 11. 1% ） quit treatment. In the remaining 60 cases, there were 16 cases （26.7%） of normal PSA levels, 24 cases （40%） effective, 12 cases （20%） stable and 8 cases （13.3%） ineffective. In terms of bone pain NRS scores, there were28 patients （77.8%） decreased, 4 cases （11.1%） stable and4 cases （11.1%） increased. After treatment, toxic and side effects were found in 68 patients, including 20 cases （29.4%） of bone marrow suppres- sion （I and II） ; 12 cases （17.6%） of bone marrow suppression （III ~ IV）, 12 cases of phlebitis （17.6%）, 8 cases of stomatitis （ 11.8% ）, 36 patients （52.9%） of alopecia, 16 cases of mild fatigue （23.5%）, 20 cases （29.4%） of hyponychium changes and 24 cases （35.3%） of gastrointestinal reaction. Conclusion： In the treat-ment of hormone refractory prostate cancer, docetaxel joint prednisone is of good effect and little toxic and side effects, which should be used widely in clinical.