睾丸切除联合最大雄激素阻断(MAB)治疗中晚期前列腺癌的疗效观察
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摘要
目的比较单纯睾丸切除与睾丸切除后联合最大雄激素阻断(maximum androgen blockade,MAB)治疗中晚期前列腺癌的临床疗效。方法将38例中晚期前列腺癌患者划分为两组。第一组为单纯睾丸切除治疗,共17例;第二组为睾丸切除加最大雄激素阻断(MAB)治疗,共21例,比较两组患者的血清前列腺特异性抗原(PSA)、尿流率、前列腺大小及生存时间和质量。结果睾丸切除联合最大雄激素阻断组治疗后患者的生活质量明显优于单纯睾丸切除治疗组;而且两组在治疗12个月后,尿流率较治疗前均显著增高,血清PSA水平均显著降低,前列腺体积均明显缩小,睾丸切除联合最大雄激素阻断疗法降低血清中PSA水平效果更佳。结论睾丸切除联合最大雄激素阻断治疗中晚期前列腺癌,不仅可延长患者生存时间,还可以提高患者生存质量。
Objective To compare the clinical efficacy between orchiectomy and orchiectomy combined with maximum androgen blockade( MAB) in the treatment of advanced prostate cancer. Methods 38 patients with advanced prostate cancer,according to the specific conditions,were divided into2 groups. The first group recceived orchiectomy only,with 17 cases; the second group recceived orchiectomy plus MAB therapy,with 21 cases,serum prostate-specific antigen( PSA),urinary rates,prostate size,and survival time and quality between the 2 groups were compared. Results After removal of the testicles,MAB group presented better quality of life and survival rate than orchiectomy group; both group presented better improvement in urinary flow rate,serum PSA level and volume of prostate,the MAB group had better effect in reducing the level of PSA. Conclusion Orchidectomy combined with MAB for advanced prostate cancer can improve survival period and quality of life for patients.
Objective To compare the clinical efficacy between orchiectomy and orchiectomy combined with maximum androgen blockade( MAB) in the treatment of advanced prostate cancer. Methods 38 patients with advanced prostate cancer,according to the specific conditions,were divided into2 groups. The first group recceived orchiectomy only,with 17 cases; the second group recceived orchiectomy plus MAB therapy,with 21 cases,serum prostate-specific antigen( PSA),urinary rates,prostate size,and survival time and quality between the 2 groups were compared. Results After removal of the testicles,MAB group presented better quality of life and survival rate than orchiectomy group; both group presented better improvement in urinary flow rate,serum PSA level and volume of prostate,the MAB group had better effect in reducing the level of PSA. Conclusion Orchidectomy combined with MAB for advanced prostate cancer can improve survival period and quality of life for patients.
引文
[1]韩苏军,张思维,陈万青,等.中国前列腺癌发病现状和流行趋势分析[J].临床肿瘤学杂志,2013,18(4):330-334.
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[6]朱扬进,宁晔,陈慧兴,等.新型中空硅橡胶睾丸假体移植术治疗睾丸缺失的临床体会(附13例报告)[J].中国男科学杂志,2012,26(3):45-48.
[7]贾文明,郭建军.绿激光汽化术联合睾丸切除加抗雄激素治疗晚期前列腺癌并膀胱出口梗阻的效果观察[J].中国综合临床,2014,30(5):540-542.
[8]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.
[9]李康,袁轶峰.氟他胺加睾丸切除治疗晚期前列腺癌22例[J].肿瘤药学,2012,2(2):148-150.
[10]黄军成,朱震平.经尿道等离子前列腺电切术、睾丸切除联合持续性雄激素阻断治疗中晚期前列腺癌疗效观察[J].临床合理用药杂志,2011,4(19):42-43.
[11]张为良,宋华英.经尿道电切术加睾丸切除治疗伴膀胱出口梗阻晚期高危前列腺癌[J].中国实用医刊,2008,35(11):47-48.
[12]彭文通.超声引导对前列腺血流信号异常区的穿刺活检对前列腺癌筛选的价值[J].实用癌症杂志,2013,28(1):89-90.
[2]陈万青.2012中国肿瘤登记年报[M].北京军事医学科学出版社,2012:100-101.
[3]Ayyathurai R,L Santos Rde,M Manoharan.Role of maximum androgen blockade in advanced prostate cancer[J].Indian J Urol,2009,25(1):47-51.
[4]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.
[5]王钢,夏安,钟光俊,等.双睾丸切除+比鲁卡胺联合疗法治疗晚期前列腺癌[J].中国现代医生,2008,46(18):131-132.
[6]朱扬进,宁晔,陈慧兴,等.新型中空硅橡胶睾丸假体移植术治疗睾丸缺失的临床体会(附13例报告)[J].中国男科学杂志,2012,26(3):45-48.
[7]贾文明,郭建军.绿激光汽化术联合睾丸切除加抗雄激素治疗晚期前列腺癌并膀胱出口梗阻的效果观察[J].中国综合临床,2014,30(5):540-542.
[8]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.
[9]李康,袁轶峰.氟他胺加睾丸切除治疗晚期前列腺癌22例[J].肿瘤药学,2012,2(2):148-150.
[10]黄军成,朱震平.经尿道等离子前列腺电切术、睾丸切除联合持续性雄激素阻断治疗中晚期前列腺癌疗效观察[J].临床合理用药杂志,2011,4(19):42-43.
[11]张为良,宋华英.经尿道电切术加睾丸切除治疗伴膀胱出口梗阻晚期高危前列腺癌[J].中国实用医刊,2008,35(11):47-48.
[12]彭文通.超声引导对前列腺血流信号异常区的穿刺活检对前列腺癌筛选的价值[J].实用癌症杂志,2013,28(1):89-90.