内分泌治疗高龄中晚期前列腺癌患者临床疗效及安全性研究
|
摘要
目的探讨高龄中晚期前列腺癌内分泌治疗的临床疗效及安全性。方法回顾性分析北部战区总医院2008—2018年采用内分泌治疗的78例高龄中晚期前列腺癌患者的临床资料。根据治疗方法的不同将其分为A组(n=31)与B组(n=47)。A组采用常规双侧睾丸切除去势术联合比卡鲁胺治疗,B组采用戈舍瑞林联合比卡鲁胺治疗。比较两组患者的中位无进展生存期(PFS)、中位总生存期(OS)及治疗相关的不良反应。结果 A、B两组患者的中位PFS、中位OS比较,差异均无统计学意义(P>0.05)。两组患者乳房胀痛、乳房发育、潮热、骨质疏松方面药物不良反应的发生率比较,差异均无统计学意义(P>0.05);B组乏力、肝酶异常的发生率显著高于A组,两组间比较,差异均有统计学意义(P<0.05)。结论在高龄中晚期前列腺癌患者中,戈舍瑞林联合比卡鲁胺治疗方案可取得与手术去势联合比卡鲁胺治疗同样的疗效,不良反应均可耐受,可作为临床治疗高龄中晚期前列腺癌的方案之一。
Objective To investigate the efficacy and safety of hormonal therapy in elderly patients with advanced prostate cancer.Methods A retrospective study was performed on 78 cases of elderly patients with advanced prostate cancer who were admitted from 2008 to 2018.They were divided into Group A(n=31) and Group B(n=47) according to different treatment methods.Conventional bilateral testicular excision and castration combined with bicalutamide were used in Group A,while goserelin combined with bicalutamide was used in Group B.Progression-free survival(PFS),overall survival(OS) and treatment-related side effects were compared between the two groups.Results There was no significant difference between the two groups in median PFS and OS(P>0.05).There was no significant difference between the two groups in the incidence of side effects of drugs in breast swelling pain,breast development,hot flashes and osteoporosis(P>0.05).The incidence of fatigue and abnormal liver enzymes in Group B was significantly higher than that in Group A,and the difference between the two groups was statistically significant(P<0.05).Conclusion In elderly patients with advanced prostate cancer,double-virtue regimen can achieve the same efficacy as surgical castration combined with bicalutamide treatment,with tolerable side effects,which can be used as one of the clinical treatment options for advanced age patients with advanced prostate cancer.
Objective To investigate the efficacy and safety of hormonal therapy in elderly patients with advanced prostate cancer.Methods A retrospective study was performed on 78 cases of elderly patients with advanced prostate cancer who were admitted from 2008 to 2018.They were divided into Group A(n=31) and Group B(n=47) according to different treatment methods.Conventional bilateral testicular excision and castration combined with bicalutamide were used in Group A,while goserelin combined with bicalutamide was used in Group B.Progression-free survival(PFS),overall survival(OS) and treatment-related side effects were compared between the two groups.Results There was no significant difference between the two groups in median PFS and OS(P>0.05).There was no significant difference between the two groups in the incidence of side effects of drugs in breast swelling pain,breast development,hot flashes and osteoporosis(P>0.05).The incidence of fatigue and abnormal liver enzymes in Group B was significantly higher than that in Group A,and the difference between the two groups was statistically significant(P<0.05).Conclusion In elderly patients with advanced prostate cancer,double-virtue regimen can achieve the same efficacy as surgical castration combined with bicalutamide treatment,with tolerable side effects,which can be used as one of the clinical treatment options for advanced age patients with advanced prostate cancer.
引文
[1] Andres E,Eschwege P,Lang H,et al.Metabolic impact of androgen deprivation therapy for prostate cancer[J].Prog Urol,2012,22(Suppl 2):S39-S47.
[2] 刘磊,侯小飞,马潞林,等.晚期前列腺癌膀胱出口梗阻患者姑息性经尿道前列腺切除术疗效评价[J].北京大学学报(医学版),2015,47(4):597-600.
[3] Vermassen T,Van Praet C,Vanderschaeghe D,et al.Capillary electrophoresis of urinary prostate glycoproteins assists in the diagnosis of prostate cancer[J].Electrophoresis,2014,35(7):1017-1024.
[4] 石远凯,孙燕.临床肿瘤内科手册(第六版)[M].北京:人民卫生出版社,2015.
[5] 马春光,叶定伟,李长岭,等.前列腺癌的流行病学特征及晚期一线内分泌治疗分析[J].中华外科杂志,2008,46(12):921-925.
[6] 张世革,王久林,吴烨,等.前列腺癌内分泌治疗的生存随访[J].中华男科医学杂志,2013,19(12):1103-1106.
[7] Hussain M,Tangen CM,Berry DL,et al.Intermittent versus continuous androgen deprivation in prostate cancer[J].N Engl J Med,2013,368(14):1314-1325.
[8] 叶杨,汪骏,秦超,等.中晚期前列腺癌单药治疗与最大限度雄激素阻断疗法的疗效及副作用观察[J].现代泌尿外科杂志,2015,20(5):380-382.
[9] Keating NL,O′Malley A,Freedland SJ,et al.Diabetes and cardiovascular disease during androgen deprivation therapy for prostate cancer[J].J Natl Cancer Inst,2012,104(19):1518-1523.
[10] Tsai HK,D′Amico AV,Sadetsky N,et al.Androgen deprivation therapy for localized prostate cancer and the risk of cardiovascular mortality[J].J Natl Cancer Inst,2007,99(20):1516-1524.
[11] Conteduca V,Di Lorenzo G,Tartarone A,et al.The cardiovascular risk of gonadotropin releasing hormone agonists in men with prostate cancer:an unresolved controversy[J].Crit Rev Oncol Hematol,2013,86(1):42-51.
[12] Nguyen PL,Je Y,Schutz FA,et al.Association of androgen deprivation therapy with cardiovascular death in patients with prostate cancer:a meta-analysis of randomized trials[J].JAMA,2011,306(21):2359-2366.
[2] 刘磊,侯小飞,马潞林,等.晚期前列腺癌膀胱出口梗阻患者姑息性经尿道前列腺切除术疗效评价[J].北京大学学报(医学版),2015,47(4):597-600.
[3] Vermassen T,Van Praet C,Vanderschaeghe D,et al.Capillary electrophoresis of urinary prostate glycoproteins assists in the diagnosis of prostate cancer[J].Electrophoresis,2014,35(7):1017-1024.
[4] 石远凯,孙燕.临床肿瘤内科手册(第六版)[M].北京:人民卫生出版社,2015.
[5] 马春光,叶定伟,李长岭,等.前列腺癌的流行病学特征及晚期一线内分泌治疗分析[J].中华外科杂志,2008,46(12):921-925.
[6] 张世革,王久林,吴烨,等.前列腺癌内分泌治疗的生存随访[J].中华男科医学杂志,2013,19(12):1103-1106.
[7] Hussain M,Tangen CM,Berry DL,et al.Intermittent versus continuous androgen deprivation in prostate cancer[J].N Engl J Med,2013,368(14):1314-1325.
[8] 叶杨,汪骏,秦超,等.中晚期前列腺癌单药治疗与最大限度雄激素阻断疗法的疗效及副作用观察[J].现代泌尿外科杂志,2015,20(5):380-382.
[9] Keating NL,O′Malley A,Freedland SJ,et al.Diabetes and cardiovascular disease during androgen deprivation therapy for prostate cancer[J].J Natl Cancer Inst,2012,104(19):1518-1523.
[10] Tsai HK,D′Amico AV,Sadetsky N,et al.Androgen deprivation therapy for localized prostate cancer and the risk of cardiovascular mortality[J].J Natl Cancer Inst,2007,99(20):1516-1524.
[11] Conteduca V,Di Lorenzo G,Tartarone A,et al.The cardiovascular risk of gonadotropin releasing hormone agonists in men with prostate cancer:an unresolved controversy[J].Crit Rev Oncol Hematol,2013,86(1):42-51.
[12] Nguyen PL,Je Y,Schutz FA,et al.Association of androgen deprivation therapy with cardiovascular death in patients with prostate cancer:a meta-analysis of randomized trials[J].JAMA,2011,306(21):2359-2366.