戈舍瑞林联合比卡鲁胺治疗中老年前列腺癌临床研究
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摘要
目的探讨戈舍瑞林联合比卡鲁胺治疗中老年前列腺癌的临床疗效。方法选取德阳市第二人民医院2015年7月到2017年6月收治的中老年前列腺癌患者80例,按随机数字表法分为对照组和试验组,各40例。对照组患者给予手术去势。两组患者均服用比卡鲁胺片(50 mg,每日1次),试验组患者加用醋酸戈舍瑞林缓释植入剂(3. 6 mg,每28天1次)。结果试验组总有效率为82. 50%,显著高于对照组的55. 00%(P <0. 05);与治疗前比较,两组患者治疗后6个月、12个月前列腺特异性抗原(PSA)、睾酮(T)水平显著降低,且试验组显著低于对照组(P <0. 05);试验组患者治疗后12个月生存率为92. 50%,显著高于对照组的70. 00%(P <0. 05);两组患者治疗后蒙特利尔认知功能(MoCA)评分均较治疗前显著降低,但试验组显著高于对照组(P <0. 05);两组不良反应发生率相当(47. 50%比42. 50%,P> 0. 05)。结论醋酸戈舍瑞林缓释植入剂联合比卡鲁胺片治疗中老年前列腺癌,可提高疗效,改善患者血清PSA及T水平,提高生存率,且对患者认知功能影响较小,不增加不良反应。
Objective To investigate the clinical effect of goserelin combined with bicalutamide in the treatment of middle-aged and elderly patients with prostate cancer. Methods Totally 80 middle-aged and elderly patients with prostate cancer admitted to The Second People's Hospital of Deyang City from July 2015 to June 2017 were selected and divided into the control group and the experimental group according to the random number table method,40 cases in each group. The patients in the control group were treated with surgical castration,both groups were given Bicalutamide Tablets( 50 mg,once a day),and the patients in the experimental group were given Goserelin Acetate Sustained-Release Depot(3. 6 mg,once every 28 days) on the basis of the control group. Results The total effective rate of the experimental group was 82. 50%,which was significantly higher than 55. 00% of the control group( P < 0. 05).Compared with before treatment,the levels of prostate specific antigen( PSA) and testosterone( T) in the two groups were significantly lower after 6 and 12 months of treatment,and those in the experimental group were significantly lower than those in the control group( P < 0. 05). The 12-month survival rate of the patients in the experimental group was 92. 50%,which was significantly higher than70. 00% in the control group( P < 0. 05). After treatment,the Montreal Cognitive Function( MoCA) score in the two groups was significantly lower than that before treatment,but that in the experimental group was significantly higher than that in the control group( P < 0. 05). There was no significant difference in the incidence of adverse reactions between the two groups( 47. 50% vs. 42. 50%,P > 0. 05). Conclusion Goserelin Acetate Sustained-Release Depot combined with Bicalutamide Tablets are effective in the treatment of middle-aged and elderly patients with prostate cancer,which can significantly improve the curative effect and the levels of serum PSA and T,and have less influence on the cognitive function without increasing the adverse reactions.
Objective To investigate the clinical effect of goserelin combined with bicalutamide in the treatment of middle-aged and elderly patients with prostate cancer. Methods Totally 80 middle-aged and elderly patients with prostate cancer admitted to The Second People's Hospital of Deyang City from July 2015 to June 2017 were selected and divided into the control group and the experimental group according to the random number table method,40 cases in each group. The patients in the control group were treated with surgical castration,both groups were given Bicalutamide Tablets( 50 mg,once a day),and the patients in the experimental group were given Goserelin Acetate Sustained-Release Depot(3. 6 mg,once every 28 days) on the basis of the control group. Results The total effective rate of the experimental group was 82. 50%,which was significantly higher than 55. 00% of the control group( P < 0. 05).Compared with before treatment,the levels of prostate specific antigen( PSA) and testosterone( T) in the two groups were significantly lower after 6 and 12 months of treatment,and those in the experimental group were significantly lower than those in the control group( P < 0. 05). The 12-month survival rate of the patients in the experimental group was 92. 50%,which was significantly higher than70. 00% in the control group( P < 0. 05). After treatment,the Montreal Cognitive Function( MoCA) score in the two groups was significantly lower than that before treatment,but that in the experimental group was significantly higher than that in the control group( P < 0. 05). There was no significant difference in the incidence of adverse reactions between the two groups( 47. 50% vs. 42. 50%,P > 0. 05). Conclusion Goserelin Acetate Sustained-Release Depot combined with Bicalutamide Tablets are effective in the treatment of middle-aged and elderly patients with prostate cancer,which can significantly improve the curative effect and the levels of serum PSA and T,and have less influence on the cognitive function without increasing the adverse reactions.
引文
[1]GU J,REN L,WANG X,et al.Expression of livin,survivin and caspase-3 in prostatic cancer and their clinical significance[J].Int J Clin Exp Pathol,2015,8(11):14034-14039.
[2]乔明洲,宋歌,张海芳,等.醋酸戈舍瑞林缓释植入剂与手术去势联合比卡鲁胺片治疗晚期前列腺癌的疗效比较[J].中国继续医学教育,2016,8(4):182-183.
[3]那彦群.实用泌尿外科学[J].中国医刊,2009,44(9):47.
[4]李利军,刘竞,马志伟,等.腹腔镜与机器人辅助腹腔镜前列腺癌根治术治疗前列腺癌的效果比较[J].广东医学,2017,38(4):563-566.
[5]曲静坤.比卡鲁胺联合戈舍瑞林间歇性治疗局部晚期前列腺癌的临床评价[J].中国药业,2016,25(11):46-48.
[6]曹爱娇,邵瑞,王.中药通过调节雄激素受体信号通路治疗前列腺癌的研究进展[J].中国临床药理学杂志,2017,33(13):1263-1266.
[7]ZHANG Q,HONG B,WU S,et al.Inhibition of prostatic cancer growth by ginsenoside Rh 2[J].Tumour Biol,2015,36(4):2377-2381.
[8]谢皇,刘怿敏,罗志刚,等.不同前列腺癌根治术的疗效对比分析[J].中国急救医学,2016,36(z1):103-104.
[9]乔鹏,邢念增.经腹膜外腹腔镜前列腺癌根治术治疗高危前列腺癌的临床研究(附49例报告)[J].中国内镜杂志,2016,22(2):87-90.
[10]LU HM,YE M.The relative bioavailability study and fasting and fed states pharmacokinetics of bicalutamide 50-mg tablets in healthy Chinese volunteers[J].Arzneimittelforschung,2012,62(1):18-21.
[11]WANG Y,XIE G,HUANG Y,et al.Calcium acetate or calcium carbonate for hyperphosphatemia of hemodialysis patients:a meta-analysis[J].PLoS One,2015,10(3):e0121376.
[12]谢云峰,黄一鸣.醋酸戈舍瑞林缓释植入剂长期应用对前列腺癌患者去势后的临床疗效与安全性[J].中国临床药理学杂志,2017,33(14):1314-1316.
[13]倪志强,杨影,张洋,等.戈舍瑞林联合比卡鲁胺片治疗前列腺癌的效果分析[J].中国卫生标准管理,2015,6(20):97-98.
[14]KOVESDY CP,LU JL,WALL BM,et al.Changes With Lanthanum Carbonate,Calcium Acetate,and Phosphorus Restriction in CKD:A Randomized Controlled Trial[J].Kidney Int Rep,2018,3(4):897-904.
[15]周利群.中国前列腺癌药物去势治疗专家共识解读[J].中华泌尿外科杂志,2017,38(z1):4-5.
[16]靳松,张天,郑颖洁,等.高危组前列腺癌根治术后雄激素剥夺治疗联合早期放射治疗对局部控制及近期生存率的影响[J].首都医科大学学报,2016,37(3):318-322.
[2]乔明洲,宋歌,张海芳,等.醋酸戈舍瑞林缓释植入剂与手术去势联合比卡鲁胺片治疗晚期前列腺癌的疗效比较[J].中国继续医学教育,2016,8(4):182-183.
[3]那彦群.实用泌尿外科学[J].中国医刊,2009,44(9):47.
[4]李利军,刘竞,马志伟,等.腹腔镜与机器人辅助腹腔镜前列腺癌根治术治疗前列腺癌的效果比较[J].广东医学,2017,38(4):563-566.
[5]曲静坤.比卡鲁胺联合戈舍瑞林间歇性治疗局部晚期前列腺癌的临床评价[J].中国药业,2016,25(11):46-48.
[6]曹爱娇,邵瑞,王.中药通过调节雄激素受体信号通路治疗前列腺癌的研究进展[J].中国临床药理学杂志,2017,33(13):1263-1266.
[7]ZHANG Q,HONG B,WU S,et al.Inhibition of prostatic cancer growth by ginsenoside Rh 2[J].Tumour Biol,2015,36(4):2377-2381.
[8]谢皇,刘怿敏,罗志刚,等.不同前列腺癌根治术的疗效对比分析[J].中国急救医学,2016,36(z1):103-104.
[9]乔鹏,邢念增.经腹膜外腹腔镜前列腺癌根治术治疗高危前列腺癌的临床研究(附49例报告)[J].中国内镜杂志,2016,22(2):87-90.
[10]LU HM,YE M.The relative bioavailability study and fasting and fed states pharmacokinetics of bicalutamide 50-mg tablets in healthy Chinese volunteers[J].Arzneimittelforschung,2012,62(1):18-21.
[11]WANG Y,XIE G,HUANG Y,et al.Calcium acetate or calcium carbonate for hyperphosphatemia of hemodialysis patients:a meta-analysis[J].PLoS One,2015,10(3):e0121376.
[12]谢云峰,黄一鸣.醋酸戈舍瑞林缓释植入剂长期应用对前列腺癌患者去势后的临床疗效与安全性[J].中国临床药理学杂志,2017,33(14):1314-1316.
[13]倪志强,杨影,张洋,等.戈舍瑞林联合比卡鲁胺片治疗前列腺癌的效果分析[J].中国卫生标准管理,2015,6(20):97-98.
[14]KOVESDY CP,LU JL,WALL BM,et al.Changes With Lanthanum Carbonate,Calcium Acetate,and Phosphorus Restriction in CKD:A Randomized Controlled Trial[J].Kidney Int Rep,2018,3(4):897-904.
[15]周利群.中国前列腺癌药物去势治疗专家共识解读[J].中华泌尿外科杂志,2017,38(z1):4-5.
[16]靳松,张天,郑颖洁,等.高危组前列腺癌根治术后雄激素剥夺治疗联合早期放射治疗对局部控制及近期生存率的影响[J].首都医科大学学报,2016,37(3):318-322.