摘要
目的探讨间歇性内分泌治疗(IHT)局限性前列腺癌的效果。方法选取局限性前列腺癌(T1-2N0M0)患者36例,全雄激素阻断治疗6～9个月,停药时机为前列腺特异性抗原(PSA)≤0.2 ng/mL后持续3～6个月,以后根据每月PSA的检测结果决定是否再行内分泌治疗。治疗期及间歇期检测血清睾酮值,并行生活质量评分。结果 36例患者间歇性内分泌治疗6个月后血清PSA均降至正常,前列腺体积明显缩小。第1～5疗程的平均间歇期分别为5.8、6.6、8.4、5.6和3.0个月。最低PSA值从第1疗程的0.001 ng/mL上升至第5疗程的0.5 ng/mL。95.6%患者在第1个间歇期睾酮回升至正常值上限,中位回归时间11.2周。全部患者完成第1个周期的治疗,88.8%的患者完成2个周期的治疗,63.8%的患者完成3个周期的治疗,47.2%的患者完成4个周期的治疗,25.0%的患者完成5个周期的治疗,随访时间1～6.5年。生活质量评分显示,患者性趣、排尿症状和肠道症状等在间歇期得到显著改善(P<0.05)。结论间歇性内分泌方法是非根治性治疗局限性前列腺癌的有效手段。
Objective To investigate the efficacy of intermittent hormonal therapy（IHT） in the treatment of local prostate cancer.Methods IHT was employed to 36 cases of local prostate cancer in the T1-2 clinical stage.After maximal androgen blockade（MAB） therapies lasted for 6～9 months when the serum PSA was decreased below 0.2ng/mL,MAB was continued for another 3～6 months.After that,the level of PSA was measured monthly to decide whether further MAB was needed.During the treatment and intermittence,serum testosterone level and quality of life score were evaluated periodically.Results After 6-month intermittent treatment,the PSA level of all the patients was reduced to normal,and the volume of prostate was significantly reduced.The average interval from the first to the fifth course of treatment was 5.8,6.6,8.4,5.6 and 3.0 months respectively.The lowest PSA value increased from 0.001ng/mL in the fist course to 0.5ng/mL in the fifth.The testosterone level of 95.6% patients returned to normal at the first intermittence,with a median recovery time of 11.2 weeks.88.8% patients completed 2 cycles of IHT,63.8% completed 3,47.2% completed 4,and 25.0% completed 5.During the follow-up of 1.0 to 6.5 years,the quality of life score showed the urinary symptoms,bowel symptoms and sexual function at the interim period were significantly improved.Conclusions IHT is an effective approach in the treatment of local prostate cancer.
出处
《现代泌尿外科杂志》
CAS
2011年第2期123-125,147,共4页
Journal of Modern Urology
