近距离照射联合内分泌治疗寡转移前列腺癌的临床观察

Combined brachytherapy with hormonal therapy in treating oligometastatic prostate cancer

目的探讨近距离照射联合内分泌治疗寡转移前列腺癌患者的临床疗效。方法回顾性分析2014年8月至2016年12月间本院收治的78例寡转移前列腺癌患者的临床资料,按治疗方法不同将入组患者分为对照组(42例)和研究组(36例),分别行单纯内分泌治疗和近距离照射联合内分泌治疗。观察指标为总生存率、肿瘤特异性生存率、影像学无进展生存期(rPFS)、无去势抵抗前列腺癌(CRPC)进展生存率和健康相关生活质量。结果两组患者中位随访时间为25.6个月,研究组患者中位rPFS为26.8(22.1~31.5)个月,高于对照组的20.4(18.6~22.2)个月(P<0.05);研究组的无CRPC进展生存率高于对照组,差异有统计学意义(P<0.05);两组间肿瘤特异性生存率及总生存率比较,差异无统计学意义(P>0.05)。两组患者的生理功能、社会功能、总健康水平和相关症状评分比较,差异无统计学意义(P>0.05);治疗1、6个月后,研究组的尿路症状评分较对照组高(P<0.05)。结论近距离照射联合内分泌治疗寡转移前列腺癌可延缓患者的疾病进展,但需要进一步研究验证。

Objective To evaluate the clinical efficacy of permanent brachytherapy combined with hormonal therapy in patients with oligometastatic prostate cancer.Methods Seventy-eight patients with oligometastatic prostate cancer from August 2014 to December 2016 in the hospital were analyzed retrospectively.Patients were divided into 2 groups according to different treatment methods.Control group(42 cases)received hormonal therapy,and study group(36 cases)underwent brachytherapy combined with hormonal therapy.Radiographic progressionfree survival(rPFS),tumor-specific survival,overall survival(OS),castration resistance prostate cancer(CRPC)free survival rate and quality of life of two groups were compared.Results The median rPFS of study group were 26.8(22.1-31.5)months,and it was longer than those of control group 20.4(18.6-22.2)months(P<0.05).When analyzed by Kaplan-Meier survival curve,there was no significant difference in cancerspecific survival rate and overall survival rate.There was also a significant difference in CRPC free survival(P<0.05).Low urinary tract symptoms occurred in 26 cases(72.2%).Urinary retention occurred in 3 cases(8.3%).No serious rectal irritation symptoms occurred.Conclusions Permanent brachytherapy combined with hormonal therapy may contribute to improve the prognosis of patients with oligometastatic prostate cancer.Prospective randomized controlled studies are necessary because of the limits of current studies.