药物去势联合放疗对前列腺癌患者的效果评估

Efficacy and safety of drug castration with radiotherapy in treatment of prostate cancer

目的探讨药物去势治疗联合根治性放射治疗前列腺癌患者的效果和安全性研究。方法选取2014年1月-2016年1月禹城市人民医院收治且年龄超过70岁的前列腺癌患者89例作为研究对象。随机分为药物去势联合根治性放疗组(观察组44例)和单纯根治性放疗组(对照组45例),观察临床疗效及不良反应发生情况,随访观察疾病中位无进展生存时间(mPFS)。结果两组客观缓解率和疾病控制率(客观缓解率61.4% VS 33.3%,疾病控制率95.5% VS 55.6%)比较,差异有统计学意义(P<0.05),观察组均高于对照组;观察组的mPFS为(36.5±3.7)个月,对照组为(19.8±2.4)个月,差异有统计学意义(P<0.05)。观察组总生存时间(OS)为(39.8±3.8)个月,对照组为(25.4±2.7)个月,差异有统计学意义(P<0.05)。多因素分析发现前列腺癌患者KPS 70~80分、淋巴结转移阳性患者、Gleason评分G8~10及单纯放疗是前列腺癌患者PFS和OD的影响因素;药物去势联合根治性放疗同样与患者OS相关。结论药物去势联合根治性放射治疗高龄前列腺癌患者有较好的生存获益,值得临床推广应用。

Objectives To evaluate the efficacy and safety of drug castration with radiotherapy in the treatment of prostate cancer.Methods From January 2014 to January 2016,the study subjects were 89 patients who aged over 70 came to our hospital were randomly divided into two groups:drug castration with radiotherapy group(n=44)and radiotherapy group(n=45);the clinical efficacy and adverse reactions were observed and calculated by Kaplan-Meier method of follow-up observed progression-free survival.Results The comparison between objective remission rate and disease control rate in the treatment group of drug castration combined with radical radiotherapy has statistical significance(objective response rate:61.4%VS 33.3%,P<0.05;disease control rate:95.5%VS 55.5%,P<0.05).Kaplan-Meier method was applied to calculate follow-up observe progression-free survival(mPFS),drug castration combined with radical radiotherapy group is(36.5±3.7)mo,radiotherapy group is(19.8±2.4)mo,and the difference was statistically significant(P<0.05);and overall survival(OS)is(39.8±3.8)mo in drug castration combined with radical radiotherapy group,(25.4±2.7)mo in radiotherapy group,the difference was statistically significant(P<0.05).Multivariate analysis found that PFS was associated with KPS scores of 70 to 80 in prostate cancer patients,positive lymph node metastasis,Gleason score G8-10 and radiotherapy alone.Drug castration combined with radical radiotherapy is also associated with OS in patients.Conclusions Drug emasculation combined with radical radiotherapy is beneficial to the survival of prostate cancer in elderly patients.