晚期前列腺癌常规治疗对比睾丸切除去势手术对患者预后的影响

Conventional Treatment of Compared with Orchiectomy and Castration for Patients with Advanced Prostate Cancer

目的研究晚期前列腺癌常规治疗对比睾丸切除去势手术对患者预后的影响。方法收集晚期前列腺癌患者临床资料80例,其中进行常规治疗有35例患者,进行睾丸切除去势手术有45例患者。手术组患者进行双侧睾丸切除手术,常规治疗组使用多西他赛化疗方案进行治疗。治疗后观察2组患者生存期及2年生存率情况,检测患者血清PSA、血清睾酮改善情况,患者前列腺症状评分(IPSS)、生活质量评分(QOL)改善情况,观察治疗中患者发生不良反应情况。结果常规治疗组患者平均生存(19.18±1.97)月,手术组为(26.47±3.10)月,2组差异有统计学意义(P<0.05)。手术组患者2年生存率达84.44%,高于常规治疗组的51.43%,差异有统计学意义(P<0.05)。2组患者治疗后,血清PSA和睾酮水平均有不同程度的下降,手术组效果优于常规治疗组(P<0.05)。治疗后手术组患者IPSS和QOL评分较治疗前明显下降(P<0.05),常规治疗组治疗前后IPSS和QOL评分差异无统计学意义(P>0.05),手术组效果优于常规治疗组(P>0.05)。2组患者出现的不良反应主要包括潮热、乏力、骨骼改变、性欲下降、心血管改变、乳腺发育和进入抵抗期等,手术组患者不良反应发生率为26.67%,低于常规治疗组的62.86%,差异有统计学意义(P<0.05)。结论去势手术治疗比常规治疗可以明显降低患者血清PSA和睾酮水平,明显改善患者的生存质量和延长患者的生存时间,且患者出现的不良反应较少。

Objective To investigate the effect of conventional orchiectomy on prognosis of patients with advanced prostate cancer. Methods The clinical data of 80 cases of advanced prostate cancer were collected. There were 35 cases of routine treatment,and 45 cases underwent orchiectomy and castration. The patients in the operation group underwent bilateral orchiectomy,and the conventional treatment group was treated with docetaxel chemotherapy. After treatment survival and 2-year survival rates of the 2 groups were observed serum PSA,the improvement of serum testosterone,patients with prostate symptom score（ IPSS）,quality of life score（ QOL） were detected the adverse reactions were observed. Results The average survival rate of the conventional treatment group was（ 19. 18 ± 1. 97） months,and the operation group was（ 26. 47 ± 3. 10） months,the difference between the 2 groups was statistically significant（ P 〈 0. 05）. The 2-year survival rate of the operation group was 84. 44%,higher than 51. 43% of the conventional treatment group,the difference was statistically significant（ P 〈 0. 05）. The 2 groups of patients after treatment,serum PSA and testosterone levels have decreased in varying degrees,the operation group was superior to the conventional treatment group（ P 〈 0. 05）. After treatment,the IPSS and the QOL score were significantly lower than that before treatment（ P 〈 0. 05）,there was no significant difference in the score of QOL and IPSS before and after treatment in the conventional treatment group（ P 〉 0. 05）,the operation group was better than the conventional therapy group（ P 〉 0. 05）. The occurrence of adverse reactions in the 2 groups of patients including hot flashes,fatigue,bone changes,decreased libido,cardiovascular changes,development and enter the stage of resistance of breast surgery patients,the adverse reaction rate was 26. 67%,lower than the conventional treatment group 62. 86%,differences between the 2 groups was statistically significant（ P 〈 0. 05）. Conclusion Surgical castration therapy than conventional therapy can significantly reduce serum PSA and testosterone levels,improve the patient’s quality of life and prolong the survival time of patients,and with less adverse reaction.