CAJ | 학술논문

目的比较间歇性和持续性内分泌治疗高危前列腺癌的临床疗效.方法 2008年1月至2009年4月收治64例高危前列腺癌患者,其中36例接受戈舍瑞林加比卡鲁胺联合治疗(间歇治疗组),28例接受双侧睾丸切除加氟他胺治疗(持续治疗组).分别对两组患者的肿瘤特异性病死率、前列腺特异抗原(PSA)下降到最低值时间、治疗开始到PSA再次升高时间以及血清睾丸酮浓度、生活质量评分等指标进行比较.结果间歇治疗组和持续治疗组随访时间分别为(28.1±8.7)个月和(26.4±10.3)个月,PSA下降到最低值时间分别为(4.0±3.6)个月和(3.8±2.1)个月,治疗开始到PSA再次升高时间分别为(24.5±14.6)个月和(20.1±12.3)个月,两组比较差异均无统计学意义(P＞0.05).在治疗第18、24和30个月时,血清睾丸酮浓度持续治疗组分别为0.85、0.88、0.89 μg/L,间歇治疗组分别为1.21、1.36、1.48μg/L;在治疗第12、18、30个月时,生活质量评分持续治疗组分别为38.7、40.5、39.8分,间歇治疗组分别为49.2、51.4、52.3分.两组血清睾丸酮浓度和生活质量评分在上述各时间点比较差异均有统计学意义(P＜0.05).结论间歇性和持续性内分泌治疗在临床疗效方面比较差异无统计学意义,但在间歇期,患者的生活质量随着血清睾丸酮浓度的增加而部分改善.
목적 비교간헐성화지속성내분비치료고위전렬선암적림상료효.방법 2008년1월지2009년4월수치64례고위전렬선암환자,기중36례접수과사서림가비잡로알연합치료(간헐치료조),28례접수쌍측고환절제가불타알치료(지속치료조).분별대량조환자적종류특이성병사솔、전렬선특이항원(PSA)하강도최저치시간、치료개시도PSA재차승고시간이급혈청고환동농도、생활질량평분등지표진행비교.결과 간헐치료조화지속치료조수방시간분별위(28.1±8.7)개월화(26.4±10.3)개월,PSA하강도최저치시간분별위(4.0±3.6)개월화(3.8±2.1)개월,치료개시도PSA재차승고시간분별위(24.5±14.6)개월화(20.1±12.3)개월,량조비교차이균무통계학의의(P＞0.05).재치료제18、24화30개월시,혈청고환동농도지속치료조분별위0.85、0.88、0.89 μg/L,간헐치료조분별위1.21、1.36、1.48μg/L;재치료제12、18、30개월시,생활질량평분지속치료조분별위38.7、40.5、39.8분,간헐치료조분별위49.2、51.4、52.3분.량조혈청고환동농도화생활질량평분재상술각시간점비교차이균유통계학의의(P＜0.05).결론 간헐성화지속성내분비치료재림상료효방면비교차이무통계학의의,단재간헐기,환자적생활질량수착혈청고환동농도적증가이부분개선.
Objective To compare the clinical efficacy between continuous and intermittent androgen deprivation in high risk prostate cancer.Methods Sixty-four patients with high risk prostate cancer were treated from January 2008 to April 2009,36 cases who accepted goserelin and bicalutamide were taken as intermittent hormonal therapy (intermittent treatment group),while 28 cases who accepted bilateral orchiectomy in addition to flutamide were regarded as continuous hormonal therapy (continuous treatment group).The comparison of tumor specific mortality,time of prostate specific antigen (PSA) to nadir,tine to PSA recurrence,serum testerone and quality of life score were assessed between the two groups.Results In continuous treatment group and intermittent treatment group,follow-up period was (26.4 ± 10.3) and (28.1 ± 8.7) months,the time of PSA to nadir was (3.8 ± 2.1 ) and (4.0 ± 3.6) months,the time to PSA recurrence was (20.1 ± 12.3) and (24.5 ± 14.6) months,respectively.There was no significant difference between the two groups.At the time of 18,24 and 30 months after therapy,serum testerone was 0.85,0.88,0.89 μg/L in continuous treatment group,while 1.21,1.36,1.48 μg/L in intermittent treatment group,respectively (P ＜ 0.05 ).Similarly,quality of life score was 38.7,40.5,39.8 scores in continuous treatment group,while 49.2,51.4,52.3 scores in intermittent treatment group at the time of 12,18 and 30 months after therapy,respectively (P ＜ 0.05 ).Conclusions Clinical efficacy could not been found between continuous and intermittent endocrinic therapy of prostate cancer.During intermittent,quality of life seems to be better and increases in accordance with serum testerone recurrence at given time.