内分泌治疗联合白蛋白结合型紫杉醇在中晚期前列腺癌患者中的应用

Application of endocrine therapy combined with paclitaxel(albumin bound) in patients with intermediate and advanced prostate cancer

目的 :观察比卡鲁胺、戈舍瑞林持续内分泌治疗联合注射用白蛋白结合型紫杉醇、泼尼松在中晚期前列腺癌患者中的临床疗效。方法:将100例确诊为中晚期前列腺癌的患者随机分为对照组和观察组各50例。对照组患者采用比卡鲁胺片联合醋酸戈舍瑞林缓释植入剂治疗,观察组在对照组用药基础上加用注射用白蛋白结合型紫杉醇和泼尼松治疗。治疗3个周期后,比较2组患者的临床疗效和不良反应。结果:观察组患者的完全缓解率(22.0%)和部分缓解率(60%)高于对照组(8%和40%,P值均<0.05);观察组患者的中位生存期和中位无进展生存期(51个月和54个月)均长于对照组(33个月和30个月,P值均<0.05)。观察组患者的临床症状(疼痛、血清前列腺特异性抗原、前列腺体积和最大尿流率)明显改善。2组患者不良反应间的差异无统计学意义(P>0.05)。结论:内分泌药物联合注射用白蛋白结合型紫杉醇和泼尼松在中晚期前列腺癌患者中的疗效较好。

Objective： To observe the efficacy of icalutamide and goserelin combined with paclitaxel （albumin bound） and prednisone in patients with intermediate and advanced prostate cancer. Methods： One hundred patients with intermediate and advanced prostate cancer were randomly divided into control group （n=50） and observation group （n=50）.The patients in the control group were treated with oral bicalutamide and goserelin acetate sustainedrelease.The patients in the observation group were treated with oral bicalutamide,goserelin acetate sustained-release,paclitaxel （albumin bound） and prednisone.After 3 cycles of treatment,the effects and adverse reactions were compared. Results： The complete remission rate and the partial remission rate of the observation group were higher than those in the control group （22.0%vs 8%,60%vs 40%,both P 〈 0.05）.The median survival time and the median progression-free survival time of the observation group were longer than those of the control group （51 months vs 33 months,54 months vs 30 months,both P 〈 0.05）.The serum prostate specific antigen,prostate volume and maximum urine flow rate of the patients in the observation group were improved.The adverse reactions between the two groups had no significant differences （all P 〉 0.05）. Conclusion： The endocrine therapy combined with paclitaxel （albumin bound） and prednisone in patients with intermediate and advanced prostate cancer can achieve good efficacy.