中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2008年
11期
770-773
,共4页
朱绍兴%陈剑晖%李永生%王彬%李启镛
硃紹興%陳劍暉%李永生%王彬%李啟鏞
주소흥%진검휘%리영생%왕빈%리계용
前列腺肿瘤%间歇性雄激素阻断%持续性雄激素阻断,生活质量%副作用
前列腺腫瘤%間歇性雄激素阻斷%持續性雄激素阻斷,生活質量%副作用
전렬선종류%간헐성웅격소조단%지속성웅격소조단,생활질량%부작용
Prostatic neoplasms%Intermittent androgen deprivation%Continuous androgen deprivation%Quality of life%Side effect
目的 比较间歇性雄激素阻断(IAD)与持续性雄激素阻断(CAD)治疗前列腺癌(PCa)的疗效及不良反应. 方法 44例PCa患者,均经前列腺穿刺活检病理确诊.分2组:①21例行IAD治疗,T2 7例、T3 9例、T4 5例,骨转移者8例.采用戈舍瑞林联合比卡鲁胺行最大限度雄激素阻断(MAB)治疗,当血清PSA下降至<0.2 ng/ml后,维持用药2个月停药.停药后进入间歇期,当PSA>10.0 ng/ml或与PCa相关的临床症状明显加重且影像学检查提示PCa病灶进展时,则结束间歇期开始下一周期的治疗.②23例行CAD治疗,T2 7例、T3 12例、T4 4例,骨转移者11例.采用戈舍瑞林联合比卡鲁胺行MAB治疗,持续用药.比较2组患者疾病进展时间、生活质量及不良反应发生情况. 结果 IAD组和CAD组患者的中位疾病进展时间分别为(36±4)和(30±4)个月,2组间比较差异无统计学意义(P=0.132).IAD组患者平均治疗周期为(15.9±2.3)个月,其中治疗期(8.6±1.5)个月、间歇期(7.3±0.8)个月.IAD组患者治疗期和间歇期的治疗相关症状评分为(55.9±16.8)分和(47.9±19.7)分,二者比较差异有统计学意义(P=0.007);治疗期和间歇期骨痛、尿路及肠道症状评分比较,差异均无统计学意义(P>0.05).CAD组患者以接受MAB治疗6个月后的首次生活质量评分为基础参考值,继续治疗5个月后,尿路症状评分明显增加(P=0.023),但骨痛、肠道症状、治疗相关症状评分无明显改变(P>0.05).IAD组潮热和乳房肿痛的发生率分别为28.6%(6/21)和19.0%(4/21),CAD组分别为60.9%(14/23)和52.2%(12/23),2组间比较差异有统计学意义(P<0.05). 结论 IAD治疗可减轻雄激素阻断造成的不良反应,提高患者生活质量,延缓PCa疾病进展的作用与CAD疗效相似.
目的 比較間歇性雄激素阻斷(IAD)與持續性雄激素阻斷(CAD)治療前列腺癌(PCa)的療效及不良反應. 方法 44例PCa患者,均經前列腺穿刺活檢病理確診.分2組:①21例行IAD治療,T2 7例、T3 9例、T4 5例,骨轉移者8例.採用戈捨瑞林聯閤比卡魯胺行最大限度雄激素阻斷(MAB)治療,噹血清PSA下降至<0.2 ng/ml後,維持用藥2箇月停藥.停藥後進入間歇期,噹PSA>10.0 ng/ml或與PCa相關的臨床癥狀明顯加重且影像學檢查提示PCa病竈進展時,則結束間歇期開始下一週期的治療.②23例行CAD治療,T2 7例、T3 12例、T4 4例,骨轉移者11例.採用戈捨瑞林聯閤比卡魯胺行MAB治療,持續用藥.比較2組患者疾病進展時間、生活質量及不良反應髮生情況. 結果 IAD組和CAD組患者的中位疾病進展時間分彆為(36±4)和(30±4)箇月,2組間比較差異無統計學意義(P=0.132).IAD組患者平均治療週期為(15.9±2.3)箇月,其中治療期(8.6±1.5)箇月、間歇期(7.3±0.8)箇月.IAD組患者治療期和間歇期的治療相關癥狀評分為(55.9±16.8)分和(47.9±19.7)分,二者比較差異有統計學意義(P=0.007);治療期和間歇期骨痛、尿路及腸道癥狀評分比較,差異均無統計學意義(P>0.05).CAD組患者以接受MAB治療6箇月後的首次生活質量評分為基礎參攷值,繼續治療5箇月後,尿路癥狀評分明顯增加(P=0.023),但骨痛、腸道癥狀、治療相關癥狀評分無明顯改變(P>0.05).IAD組潮熱和乳房腫痛的髮生率分彆為28.6%(6/21)和19.0%(4/21),CAD組分彆為60.9%(14/23)和52.2%(12/23),2組間比較差異有統計學意義(P<0.05). 結論 IAD治療可減輕雄激素阻斷造成的不良反應,提高患者生活質量,延緩PCa疾病進展的作用與CAD療效相似.
목적 비교간헐성웅격소조단(IAD)여지속성웅격소조단(CAD)치료전렬선암(PCa)적료효급불량반응. 방법 44례PCa환자,균경전렬선천자활검병리학진.분2조:①21례행IAD치료,T2 7례、T3 9례、T4 5례,골전이자8례.채용과사서림연합비잡로알행최대한도웅격소조단(MAB)치료,당혈청PSA하강지<0.2 ng/ml후,유지용약2개월정약.정약후진입간헐기,당PSA>10.0 ng/ml혹여PCa상관적림상증상명현가중차영상학검사제시PCa병조진전시,칙결속간헐기개시하일주기적치료.②23례행CAD치료,T2 7례、T3 12례、T4 4례,골전이자11례.채용과사서림연합비잡로알행MAB치료,지속용약.비교2조환자질병진전시간、생활질량급불량반응발생정황. 결과 IAD조화CAD조환자적중위질병진전시간분별위(36±4)화(30±4)개월,2조간비교차이무통계학의의(P=0.132).IAD조환자평균치료주기위(15.9±2.3)개월,기중치료기(8.6±1.5)개월、간헐기(7.3±0.8)개월.IAD조환자치료기화간헐기적치료상관증상평분위(55.9±16.8)분화(47.9±19.7)분,이자비교차이유통계학의의(P=0.007);치료기화간헐기골통、뇨로급장도증상평분비교,차이균무통계학의의(P>0.05).CAD조환자이접수MAB치료6개월후적수차생활질량평분위기출삼고치,계속치료5개월후,뇨로증상평분명현증가(P=0.023),단골통、장도증상、치료상관증상평분무명현개변(P>0.05).IAD조조열화유방종통적발생솔분별위28.6%(6/21)화19.0%(4/21),CAD조분별위60.9%(14/23)화52.2%(12/23),2조간비교차이유통계학의의(P<0.05). 결론 IAD치료가감경웅격소조단조성적불량반응,제고환자생활질량,연완PCa질병진전적작용여CAD료효상사.
Objective To compare the efficacy and side effects of intermittent androgen depriva-tion (IAD) versus continuous androgen deprivation (CAD) in prostate cancer. Methods Forty-four patients with prostate cancer were divided into 2 groups. Twenty-one cases (group IAD) received IAD therapy. Of them, TNM staging showed T2 in 7 cases, T3 in 9 cases, T4 in 5 cases. The patients were treated by maximum androgen blockage until the serum PSA decreased to less than 0.2 ng/ml and maintained for 2 months. The treatment was resumed when the serum PSA increased up to 10.0 ng/ml or the symptoms occurred progress. Twenty-three cases (group CAD) underwent CAD therapy. Of them, TNM staging showed T2 in 7 cases,T3 in 12 cases,T4 in 4 cases. The time to prostate cancer progression,quality of life and side effect rate were compared between the 2 groups. Results The median time to disease progression was (36±4) months in group IAD and (30±4) months in group CAD,respectively. There was no significant difference between the 2 groups (P=0.132). The mean cycle length was (15.9±2.3) months, among them time on treatment and time off treatment were(8.8±1.5) months and (7.3±0.8) months, respectively. The symptom scores related to treatment in the treatment period and intermission of IAD group were 55.9±16.8 and 47.9±19.7, respective-ly, there was significant difference between them(P=0.007). But the differences between the treat-ment period and intermission in bone pain,urinary and intestinal symptoms were not significant (P> 0.05). The urinary symptom scores after 5 months of continuing treatment in groug CAD was signifi-cantly higher than the basis reference value which was obtained in the sixth month of initial treatment(P=0. 023), but there was no significant changes in the scores of bone pain, intestinal symptoms and symptoms related to treatment(P>0.05). The incidences of hot flash and gynecomastia were 28.6% (6/21) and 19.0%(4/21) in group IAD, 60.9%(14/23) and 52.2%(12/23) in group CAD, respec-tively. There were significant differences between the 2 groups(P<0.05). Conclusions IAD thera-py can alleviate the side effects of androgen deprivation therapy and improve the life quality. The effica-cy of prolonging the time to androgen independence of IAD therapy is similar to CAD therapy.
