CAJ | 학술논문

目的：探讨在长期进行促黄体生成激素释放激素拟似剂（ LHRH-A）去势治疗的局部晚期前列腺癌患者出现生化进展后，转换为其他LHRH拟似剂治疗后的有效性。方法37例采用戈舍瑞林或亮丙瑞林进行去势治疗的前列腺癌患者出现生化进展后，依据其药物转换前注射的LHRH-A的种类进行LHRH拟似剂的转换。26例既往行戈舍瑞林3.6 mg治疗者转换为亮丙瑞林3.75 mg，每28天皮下注射（ GA-LA组）；11例既往亮丙瑞林治疗者转换为戈舍瑞林3.6 mg，每28天注射（ LA-GA组）。每月复查前列腺特异性抗原（ PSA）及血清睾酮水平，并进行简明疼痛评分表调查。结果 GA-LA组16例（61.54%）转换后出现PSA下降，最大PSA下降比率50.81%。LA-GA组转换后7例（63.64%）出现PSA下降，最大PSA下降比率48.22%。相同时间点两组间PSA下降比率均无统计学差异。转换前2例血清睾酮水平大于40 ng/dl，转换后血清睾酮均降至40 ng/dl以下。相同时间点GA-LA组与LA-GA组之平均睾酮水平亦无统计学差异。研究期间无患者出现疼痛进展/缓解。结论对于正在长期进行LHRH-A治疗的局部晚期前列腺癌患者，出现PSA升高时，对现用的LHRH拟似剂进行种类的转换，可使部分患者PSA进展得到短期控制而获益，延缓进展至去势抵抗性前列腺癌的时间。
목적：탐토재장기진행촉황체생성격소석방격소의사제（ LHRH-A）거세치료적국부만기전렬선암환자출현생화진전후，전환위기타LHRH의사제치료후적유효성。방법37례채용과사서림혹량병서림진행거세치료적전렬선암환자출현생화진전후，의거기약물전환전주사적LHRH-A적충류진행LHRH의사제적전환。26례기왕행과사서림3.6 mg치료자전환위량병서림3.75 mg，매28천피하주사（ GA-LA조）；11례기왕량병서림치료자전환위과사서림3.6 mg，매28천주사（ LA-GA조）。매월복사전렬선특이성항원（ PSA）급혈청고동수평，병진행간명동통평분표조사。결과 GA-LA조16례（61.54%）전환후출현PSA하강，최대PSA하강비솔50.81%。LA-GA조전환후7례（63.64%）출현PSA하강，최대PSA하강비솔48.22%。상동시간점량조간PSA하강비솔균무통계학차이。전환전2례혈청고동수평대우40 ng/dl，전환후혈청고동균강지40 ng/dl이하。상동시간점GA-LA조여LA-GA조지평균고동수평역무통계학차이。연구기간무환자출현동통진전/완해。결론대우정재장기진행LHRH-A치료적국부만기전렬선암환자，출현PSA승고시，대현용적LHRH의사제진행충류적전환，가사부분환자PSA진전득도단기공제이획익，연완진전지거세저항성전렬선암적시간。
Objective To investigate the efficacy of luteinizing hormone-releasing hormone agonist( LHRH-A)switching to treat the biochemical recurrence of advanced prostate cancer. Methods Thirty-seven advanced prostate cancer patients who received goserelin or leuprol-ide treatment and had biochemical progression were rechallenged with the other LHRH-A. The patients were divided into GA-LA group( gosere-lin followed by leuprolide,n=26)and LA-GA group(leuprolide followed by goserelin,n=11). Serum prostatic specific antigen(PSA),tes-tosterone and pain evaluation were achieved following the switching treatment. Results PSA decreased in 16 patients(61. 54%)in GA-LA group and 7 patients(63. 64%)in LA-GA group after the LHRH-A switching. The maximum decreases of PSA were 50. 81% and 48. 22% in GA-LA group and LA-GA group,respectively. There were no significant differences in PSA decrease rate and serum testosterone level between two groups at any time points. No pain progression occurred during follow-up. Conclusion Some advanced prostate cancer patients with PSA progression after long term LURH-A treatment would benefit from LHRH-A switching for a short term,which delays the development of castra-tion resistant prostate cancer.