戈舍瑞林植入剂或手术去势联合比卡鲁胺治疗晚期前列腺癌临床评价

Clinical Evaluation on Goserelin Implant and Surgical Castration Combined with Bicalutamide in the Treatment of Advanced Prostate Cancer

目的探讨戈舍瑞林植入剂与手术去势分别联合比卡鲁胺治疗晚期前列腺癌(PCa)的临床疗效。方法选取医院2014年1月至2017年1月收治的晚期PCa患者98例,按治疗方法的不同分为A组(48例)和B组(50例)。两组患者均予PCa常规基础治疗,在此基础上,A组患者予戈舍瑞林植入剂联合比卡鲁胺片治疗,B组患者予手术去势、常规化学治疗联合比卡鲁胺片治疗,两组药物治疗均持续3个月,且出院后均随访1年,随访截止时间为患者死亡或2018年1月31日。结果 A组总有效率为87. 50%,明显高于B组的64. 00%(χ^2=7. 314,P=0. 007 <0. 01);治疗后,两组患者血清前列腺特异性抗原(PSA)水平及临床症状评分均明显下降,生活质量评分均明显升高,且A组改善效果明显优于B组(P <0. 05);A组与B组患者不良反应发生率相当(18. 75%比16. 00%,χ^2=0. 129,P=0. 719> 0. 05)。结论戈舍瑞林植入剂联合比卡鲁胺治疗晚期PCa的疗效优于手术去势、常规化学治疗联合比卡鲁胺,患者的PSA水平、临床症状和生活质量改善效果更佳,且不增加不良反应。

Objective To investigate the clinical efficacy of goserelin implant and surgical castration combined with bicalutamide in the treatment of advanced prostate cancer ( PCa ). Methods Totally 98 patients with advanced PCa admitted to our hospital from January 2014 to January 2017 were selected and divided into group A ( n = 48 ) and group B ( n = 50 ) according to different treatment methods. The patients in the two groups were given routine basic treatment for PCa. On this basis,the patients in group A were treated with goserelin implant combined with Bicalutamide Tablets,while the patients in group B were treated with surgical castration,routine chemotherapy combined with Bicalutamide Tablets. The patients in the two groups were treated with drugs for 3 months and followed up for 1 year after discharge,and the deadline for follow - up was death or January 31,2018. Results The total effective rate of group A was 87. 50%,which was significantly higher than 64. 00% of group B (χ^2 = 7. 314,P = 0. 007 < 0. 01 ). After treatment,the level of serum prostate specific antigen ( PSA ) and the score of clinical symptom were significantly decreased,the quality of life score were sig- nificantly increased in the two groups,and the improvement of group A was significantly better than that of group B ( P < 0. 05 ). The incidence of adverse reactions in group A was similar to that in group B ( 18. 75% vs. 16. 00%,χ^ 2 = 0. 129,P = 0. 719 > 0. 05 ). Conclusion The efficacy of goserelin implant combined with bicalutamide in the treatment of advanced PCa is better than that of sur- gical castration or routine chemotherapy combined with bicalutamide,and the former has better effect on improving PSA level,clinical symptoms and quality of life without increasing adverse reactions.