手术去势联合间歇性雄激素全阻断疗法治疗局部进展期前列腺癌的临床效果

Clinical observation of surgical castration combined with intermittent androgenic blockade therapy for locally advanced prostate cancer

目的评价手术去势与间歇性雄激素全阻断疗法联合治疗局部进展期前列腺癌(LAPC)的临床疗效。方法选择2012年1月~2014年12月我院收治的LAPC患者96例,随机分为对照组和观察组,每组48例。两组均行切除双侧睾丸手术去势治疗,观察组在此基础上采用间歇性雄激素全阻断疗法,比较两组的治疗效果。结果治疗后,两组血清PSA水平均较治疗前明显下降(P<0.05),而观察组下降幅度更大,在治疗后1周,治疗后1、3、6、9、12个月时均显著低于对照组(P<0.05);观察组PFS和OS时间显著长于对照组(P<0.05),且术后QLQ-PR25评分明显优于对照组(P<0.05)。结论手术去势联合间歇性雄激素全阻断疗法治疗LAPC,疗效肯定,可明显延长患者的无进展生存时间(PFS)和总生存时间(OS)时间,提高患者生存质量。

Objective To evaluate the clinical efficacy of surgical castration combined with intermittent androgenic blockade therapy in the treatment of locally advanced prostate cancer （LAPC）.Methods 96 patients with LAPC treated in our hospital from January 2012 to December 2014,were randomly divided into control group and observation group,48 cases in each group.All were treated with bilateral testicular surgery on the basis, observation group was given intermittent an- drogen blockade therapy.The therapeutic effects of the two groups were compared.Results After treatment, the levels of serum PSA in the two groups were significantly lower than those before treatment （P〈0.05）,while the observation group decreased more significantly （P〈0.05）.The PSA level of the observation group was significantly lower than that of the control group at 1 w and 1,3,6,9,and 12 months after treatment （P〈0.05）.PFS and OS in the observation group were significantly longer than those in the control group（P〈0.05）, and the QLQ-PR 25 score was significantly better than that of the control group （P〈0.05）.Conclusion Surgical castratio,combined with intermittent androgen total blockade therapy for LAPC, the efficacy of certain, can significantly extend the patient＇s PFS and OS time,improve patient quality of life.