CAJ | 학술논문

目的：探讨调强适形放射治疗( intensity modulated radiation therapy, IMRT)联合间歇性内分泌治疗( intermittent hormonal therapy, IHT)方法治疗局限性前列腺癌的疗效评价。方法将72例同期局限性前列腺癌患者随机分为两组,分别进行调强适形放射治疗联合间歇性内分泌治疗(37例)和单纯调强适形放射治疗(35例),分析比较两组患者的临床症状缓解率、前列腺体积变化、血清前列腺特异性抗原( PSA)值改变、肿瘤控制率、放疗不良反应发生率及生存率。结果随访5~118个月,平均56个月,联合治疗组与单纯治疗组比较,临床症状缓解率、前列腺体积差值、血清PSA<0.2μg/L者所占比例及治疗后1年、3年、5年和8年的PSA无进展生存率差异均有统计学意义( P<0.05)；治疗后1年、3年两组均无死亡病例,差异无统计学意义,治疗后5年、8年的生存率和早期放疗不良反应发生率两组间差异均有统计学意义( P<0.05)。结论调强适形放射治疗联合间歇性内分泌治疗方法治疗局限性前列腺癌可明显缓解患者的临床症状,降低血清PSA水平,提高疾病控制率及生存率,降低放疗早期不良反应发生率,疗效优于单纯调强适形放射治疗,是一种安全、有效的治疗措施。
목적：탐토조강괄형방사치료( intensity modulated radiation therapy, IMRT)연합간헐성내분비치료( intermittent hormonal therapy, IHT)방법치료국한성전렬선암적료효평개。방법장72례동기국한성전렬선암환자수궤분위량조,분별진행조강괄형방사치료연합간헐성내분비치료(37례)화단순조강괄형방사치료(35례),분석비교량조환자적림상증상완해솔、전렬선체적변화、혈청전렬선특이성항원( PSA)치개변、종류공제솔、방료불량반응발생솔급생존솔。결과수방5~118개월,평균56개월,연합치료조여단순치료조비교,림상증상완해솔、전렬선체적차치、혈청PSA<0.2μg/L자소점비례급치료후1년、3년、5년화8년적PSA무진전생존솔차이균유통계학의의( P<0.05)；치료후1년、3년량조균무사망병례,차이무통계학의의,치료후5년、8년적생존솔화조기방료불량반응발생솔량조간차이균유통계학의의( P<0.05)。결론조강괄형방사치료연합간헐성내분비치료방법치료국한성전렬선암가명현완해환자적림상증상,강저혈청PSA수평,제고질병공제솔급생존솔,강저방료조기불량반응발생솔,료효우우단순조강괄형방사치료,시일충안전、유효적치료조시。
Objective To investigate the clinical therapeutic effect of intensity modulated radiation therapy ( IMRT) combined with intermittent hormonal therapy ( IHT) for localized prostate cancer. Method 72 patients with localized prostate cancer of same stage were randomized into two groups, receiving IMRT+IHT ( 37 cases) or simple IMRT ( 35 ca-ses) , and the clinical response rate, prostate volume, serum PSA, tumor control rate, adverse events incidence and survival rate of the two groups were compared. Result All patients were followed up for 5 to 118 months and mean time was 56 months. The clinical response rate, difference of prostate volume, proportion of patients with serum PSA<0.2μg/L, and the PSA-free survival rate in 1, 3, 5, and 8 years after treatment showed statistically significant difference be-tween the two groups ( P<0.05);There was no death in 1 and 3 years after treatment in both groups, which was not statis-tically different, while the survival rate of the two groups in 5 and 8 years post treatment showed statistically significant difference ( P<0.05) . Conclusion IMRT + IHT effectively relieve clinical symptoms of patients, and lower serum PSA level, improve tumor control rate and survival rate as well as reduce adverse events, which is a safe and effective remedy with better therapeutic effect than simple IMRT.