摘要
目的：检测血清睾酮并分析其对局部进展期前列腺癌内分泌治疗的作用,以探讨局部进展期前列腺癌的良好治疗方法。方法：2013年11月~2014年10月我院诊断为局部进展期前列腺癌而行内分泌治疗患者52例,其中27例采用间歇性雄激素阻断治疗（IAD组）,25例给予持续性雄激素阻断治疗（CAD组）,连续检测两组患者血清睾酮水平,定期检测两组患者血清前列腺特异抗原（PSA）及临床症状,根据生活质量调查量表EORTC QLQ-PR25对患者生存质量数据进行记录,对两组患者分析比较其临床症状缓解情况、前列腺癌进展时间、用药剂量及治疗费用、患者生活质量及副反应发生情况。结果：治疗前IAD组与CAD组血清PSA、睾酮水平比较差异无统计学意义（P〉0.05）。治疗中,两组间无进展生存率差异有统计学意义（P〈0.05）,平均药物费用IAD组与CAD组比较差异有统计学意义（P〈0.05）;在IAD组,患者的尿路症状、治疗相关症状及性功能情况比CAD组有较好改善（P〈0.05）。治疗后,两组患者的肠道症状差异无统计学意义（P〉0.05）;热潮症状、乳房胀痛频率以及治疗后的满意程度的差异有统计学意义（P〈0.05）。结论：在前列腺癌的内分泌治疗中,血清睾酮水平检测可作为去势水平的定量指标并指导临床用药,降低药物毒副作用,延长用药间歇期,结合血清PSA可评判患者的病情发展及预后。IAD治疗较之CAD治疗前列腺癌作用更好,是治疗局部进展期前列腺癌有效的内分泌治疗方式。
Objective：To analyze the role of serum testosterone in endocrine therapy for patients with locally advanced prostate cancer,and to explore a new method and a good monitoring index for the hormonal therapy.Method：We retrospectively reviewed 52 consecutive patients with locally advanced prostate cancer from November2013 to October 2014.All the patients were performed with androgen-deprivation therapy.Intermittent androgen deprivation（IAD）was performed in 27 cases and continuous androgen deprivation（CAD）in 25 patients.We monitored the level of serum testosterone consecutively.Also,the response to therapy and diseases＇ occurrence and progression were monitored by observing patients＇ prostate-specific antigen（PSA）.Then,EORTC QLQ-PR25 was used to evaluate patients＇ quality of life.Finally,patients＇ clinical symptoms,the incidence of prostate cancer progression,dosage and cost of treatment,the patients＇ quality of life and side effects were analysed and compared between the two groups.Result：The difference of serum PSA and testosterone levels before treatment showed no significance between the IAD group and the CAD group（P〉0.05）.During the period of treatment,the difference of progression-free survival and the average drug cost were significant between the two groups（P〈0.05）.In group IAD,patients＇ urinary symptoms,treatment related symptoms and sexual function improved better than those of the CAD group（P〈0.05）.After the treatment,no significant difference was found in intestinal symptoms between the two groups of patients（P〉0.05）.However,there existed significant difference in fever symptoms,frequency of breast distending pain and rate of satisfaction between two groups（P〈0.05）.Conclusion：For patients with locally advanced prostate cancer,serum testosterone can be regarded as a quantitative index in monitoring of castration and guiding clinical administration in endocrine therapy so as to reduce the side effects of androgen deprivation and prolong the intermission of drug administration.Moreover,serum testosterone combined with PSA can be used to evaluate patients＇ disease progression and prognosis.It is concluded that IAD as an effective treatment would be superior to CAD in treating locally advanced prostate cancer.
出处
《临床泌尿外科杂志》
2016年第4期321-325,共5页
Journal of Clinical Urology
关键词
前列腺癌
血清睾酮检测
内分泌治疗
prostate cancer
serum testosterone monitoring
endocrine therapy
