戈舍瑞林联合比卡鲁胺治疗转移性前列腺癌术后患者的临床效果

Clinical effect of goserelin combined with bicalutamide on patients after metastatic prostate cancer operation

目的探讨戈舍瑞林联合比卡鲁胺治疗转移性前列腺癌术后患者的临床效果。方法选取2014年6月至2015年6月浙江省金华市中心医院收治的转移性前列腺癌患者104例。根据随机数字表法将患者分为对照组和观察组，各52例。患者进行双侧睾丸切除手术去势治疗，术后对照组进行常规治疗及护理，观察组在对照组基础上给予比卡鲁胺（50mg／次、1次／d口服）联合戈舍瑞林（3．6mg／次，每4周1次腹壁皮下注射）治疗。比较2组患者临床疗效、治疗前与治疗后1、3、6、12个月血清前列腺特异性抗原（PSA）水平及不良反应发生率。结果观察组治疗总有效率明显高于对照组[90．4％（47／52）比69．2％（36／52）]，差异有统计学意义（P〈0．05）。治疗后1、3、6、12个月，观察组血清PSA水平均明显低于对照组[（8．6±3．6）μg/L比（21．4±5．8）μg/L，（4．8±1．7）μg/L比（16．5±4．2）μg/L，（3．2±1．1）μg/L比（11．2±3．3）μg/L，（2．8±0．9）μg/L比（9．0±2．7）μg/L]，且2组患者血清PSA水平均明显低于治疗前[观察组：（96．9±35．1）μg/L；对照组：（96．6±34．6）μg/L]，差异均有统计学意义（均P〈0．05）。2组患者不良反应发生率比较，差异无统计学意义（P〉0．05）。结论转移性前列腺癌患者手术去势后采用戈舍瑞林联合比卡鲁胺治疗，可明显提高患者治疗效果，有效控制血清PSA水平，且不会提高患者不良反应发生率，治疗安全性高。

Objective To explore the clinical effect of goserefin combined with bicalutamide on patients after metastatic prostate cancer operation. Methods Totally 104 patients with metastatic prostate cancer from June 2014 to June 2015 in Jinhua Central Hospital in Zhejiang Province were randomly divided into control group and observation group, with 52 cases in each group. After bilateral orchiectomy, the control group had normal nursing and treatment; the observation group had bicalutamide 50 mg/time, 1 time/d orally and goserclin 3.6 rag/time, once every 4 weeks subcutaneous injection. The serum level of prostate specific antigen （PSA） was tested before and 1, 3, 6, 12 month after treatment. Clinical efficacy and incidence of adverse reaction were analyzed. Results The total effective rate in observation group was significantly higher than that in control group [ 90. 4% （47/52） vs 69.2% （36/52）] （P 〈 0. 05）. Serum levels of PSA after 1, 3, 6, 12 months in observation group were significantly lower than those in control group [ （ 8.6 ± 3.6 ）μg/L vs （21.4 ± 5. 8 ）μg/L, （4. 8 ± 1.7 ） μg/L vs （16. 5 ±4.2）μg/L,（3.2±1.1）μg/L vs （11.2 ±3. 3）μg/L,（2. 8 ±0. 9）μg/L vs （9.0±2.7）μg/L]（P〈0.05）. Serum levels of PSA after treatment were significantly lower than those before treatment in both group [ observation group ： （ 96. 9 ± 35.1 ） μg/L ; coutrol group ： （ 96. 6 ± 34. 6 ） μg/L ] （ P 〈 0. 05 ）. The incidence of adverse reactions had no significant difference between groups （ P 〉 0. 05 ）. Conclusion Postoperative application of goserelin and bicalutamide can improve effect of orchiectomy on patients with metastatic prostate cancer and control serum level of PSA.