经尿道前列腺电切联合内分泌治疗晚期前列腺癌疗效分析
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摘要
目的探讨经尿道前列腺电切术(TURP)联合内分泌治疗晚期前列腺癌的临床疗效。方法选择2010年1月至2012年1月泌尿外科收治的80例晚期前列腺癌患者,根据治疗时间的不同分为实验组和对照组各40例。所有患者均行经尿道前列腺电切加双侧睾丸切除术治疗,对照组在此基础上不再行其他特殊治疗,实验组则在此基础上辅以内分泌治疗(氟他胺,每次0.25g,每天3次口服),3个月后复查前列腺特异抗原(PSA),比较患者术前、术后最大尿流速、膀胱残余尿量及血PSA下降情况,国际前列腺症状评分(IPSS)及生活质量评分(QOL),统计患者1年、2年、3年生存率。结果术后第6个月,实验组患者IPSS、QOL评分、最大尿流速、残余尿量及血PSA等指标均显著优于对照组(P<0.01)。实验组患者在术后1年、2年、3年生存率上均显著高于对照组,差异均有统计学意义(P<0.05)。结论晚期前列腺癌患者应用TURP加双侧睾丸切除术安全有效,辅以内分泌治疗疗效更好。
Objective To investigate the efficacy of transurethral resection of prostate(TURP)combined with hormone theraphy in the treament of advanced prostate cancer.Methods 80patients with advanced prostate cancer admitted to urology department from Jan,2010to Jan,2012,were divided into the experimental group and the control group with 40cases in each group according to their treatment time.All patients underwent TURP and bilateral orchidectomy,based on which flutamide was given to the experimental group three times a day with 0.25g each time by oral administration.No special treatment was added to the control group.The prostate-specific antigen(PSA)of both groups were reexamined after 3months of treatment.Then,their maximum urinary flow rate,bladder urine residue, decrease of blood PSA,international prostate symptom score(IPSS)and quality of life(QOL)score before and after treatment were compared.In addition,their survival rate in the 1st year,second year and third year were counted.Results After 6months of treatment,indexes including IPSS,QOL score,maximum urinary flow rate,bladder urine residue and blood PSA of the experimental group were significantly better than those of the control group,so the difference was statistically significant(P <0.01).And their first year,second year and third year survival rates were also obviously higher than those of the control group,so the difference was statistically significant(P <0.05).Conclusion TURP and bilateral orchidectomy is safe and effective for patients with advanced prostate cancer.If hormone therapy was added to it,it will have better curative effect.
Objective To investigate the efficacy of transurethral resection of prostate(TURP)combined with hormone theraphy in the treament of advanced prostate cancer.Methods 80patients with advanced prostate cancer admitted to urology department from Jan,2010to Jan,2012,were divided into the experimental group and the control group with 40cases in each group according to their treatment time.All patients underwent TURP and bilateral orchidectomy,based on which flutamide was given to the experimental group three times a day with 0.25g each time by oral administration.No special treatment was added to the control group.The prostate-specific antigen(PSA)of both groups were reexamined after 3months of treatment.Then,their maximum urinary flow rate,bladder urine residue, decrease of blood PSA,international prostate symptom score(IPSS)and quality of life(QOL)score before and after treatment were compared.In addition,their survival rate in the 1st year,second year and third year were counted.Results After 6months of treatment,indexes including IPSS,QOL score,maximum urinary flow rate,bladder urine residue and blood PSA of the experimental group were significantly better than those of the control group,so the difference was statistically significant(P <0.01).And their first year,second year and third year survival rates were also obviously higher than those of the control group,so the difference was statistically significant(P <0.05).Conclusion TURP and bilateral orchidectomy is safe and effective for patients with advanced prostate cancer.If hormone therapy was added to it,it will have better curative effect.
引文
[1]吴江平,郭宇明,严文兵,等.经尿道前列腺电切联合内分泌治疗晚期前列腺癌疗效观察[J].实用医学杂志,2010,26(14):2590-2592.
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[3]俞弘颀,赵雪志,陈齐峰,等.TURP结合抗雄激素干预治疗中晚期前列腺癌36例[J].暨南大学学报(自然科学与医学版),2009,30(6):678-680.
[4]郑荣寿,张思维,吴良有,等.中国肿瘤登记地区2008年恶性肿瘤发病和死亡分析[J].中国肿瘤,2012,21(1):1-12.
[5]胡丽娟.经尿道等离子前列腺电切术联合间歇内分泌治疗晚期前列腺癌[J].当代医学,2012,18(25):48-49.
[6]庄仁汉,黎明,林炳森,等.经尿道电切结合间歇性内分泌治疗晚期前列腺癌20例报告[J].临床泌尿外科杂志,2006,21(6):432-433.
[7]孙继建,陈春晓,李海营,等.经尿道前列腺电切联合内分泌治疗高龄前列腺癌疗效观察[J].新乡医学院学报,2008,25(5):519-520.
[8]苑辉卿,杨玲玲,姜安丽,等.槲皮素对前列腺癌细胞增殖及转录因子Sp1功能的抑制作用[J].中国生物化学与分子生物学报,2005,21(5):673-678.
[9]Jacobsen SJ,Cirman CJ,Cuess HA,et al.Natural history of prostatism:longitudinal changes in voiding symptoms in community dwelling men[J].J Urol,1996,155(2):595-600.
[10]汪自力,易炜,陈刚,等.经尿道等离子电切联合内分泌治疗晚期前列腺癌导致下尿路梗阻的临床疗效[J].中华腔镜泌尿外科杂志(电子版),2011,5(3):222-224.
[2]张劲松,王光,刘健和,等.内分泌疗法联合经尿道前列腺电切术治疗伴有重度膀胱出口梗阻的晚期前列腺癌临床观察[J].昆明医学院学报,2010,31(2):73-75.
[3]俞弘颀,赵雪志,陈齐峰,等.TURP结合抗雄激素干预治疗中晚期前列腺癌36例[J].暨南大学学报(自然科学与医学版),2009,30(6):678-680.
[4]郑荣寿,张思维,吴良有,等.中国肿瘤登记地区2008年恶性肿瘤发病和死亡分析[J].中国肿瘤,2012,21(1):1-12.
[5]胡丽娟.经尿道等离子前列腺电切术联合间歇内分泌治疗晚期前列腺癌[J].当代医学,2012,18(25):48-49.
[6]庄仁汉,黎明,林炳森,等.经尿道电切结合间歇性内分泌治疗晚期前列腺癌20例报告[J].临床泌尿外科杂志,2006,21(6):432-433.
[7]孙继建,陈春晓,李海营,等.经尿道前列腺电切联合内分泌治疗高龄前列腺癌疗效观察[J].新乡医学院学报,2008,25(5):519-520.
[8]苑辉卿,杨玲玲,姜安丽,等.槲皮素对前列腺癌细胞增殖及转录因子Sp1功能的抑制作用[J].中国生物化学与分子生物学报,2005,21(5):673-678.
[9]Jacobsen SJ,Cirman CJ,Cuess HA,et al.Natural history of prostatism:longitudinal changes in voiding symptoms in community dwelling men[J].J Urol,1996,155(2):595-600.
[10]汪自力,易炜,陈刚,等.经尿道等离子电切联合内分泌治疗晚期前列腺癌导致下尿路梗阻的临床疗效[J].中华腔镜泌尿外科杂志(电子版),2011,5(3):222-224.