前列腺癌去雄激素治疗不良反应的预防和处理

目的观察去雄激素治疗前列腺癌的不良反应,并探讨其预防和治疗。方法回顾性分析1998年7月-2006年1月112例去雄激素治疗晚期前列腺癌的临床资料。结果112例患者中,97例完成了不良反应的调查。随访3-36月,去雄激素治疗后潮热、性功能障碍、病理性骨折发生率分别为46％、75％、4％;患者潮热、精神疲乏、四肢乏力、纳差症状明显加重(P<0．05);性功能明显减退(P<0．05)。12例潮热症状严重者使用抗抑郁药博乐欣(25mg,tid)1-2周症状减轻。7例有骨转移性疼痛或严重骨质疏松患者,应用唑来膦酸4mg静脉滴注,每45d一次,骨痛症状缓解。结论去雄激素对前列腺癌患者生活质量有一定影响。博乐欣可减轻患者潮热症状,唑来膦酸可预防和治疗去雄激素相关的骨质疏松并发症。

The prevention and management of the side effects of androgen deprivation therapy for prostate cancer

Objective To investigate the side effects of androgen deprivation therapy for prostate cancer and evaluate their prevention and management. Methods From July 1998 to January 2006, 112 cases of local advanced and metastatic prostate cancer undergoing ADT were analyzed retrospectively. Results 97 cases were followed up for 3 to 36 months. After ADT, the morbidity of hot flashes, sex dysfunction and pathological fractures was 46%, 75%, 4% respectively. The symptoms of hot flashes, fatigue, poorly appetite, sex dysfunction were worsen compared with pretreatment (P<0.05). After receiving venlafaxine hydrochloride (25mg,t.i.d) for 1-2weeks, the symptoms of hot flashes were reduced in 12 serious cases. For 7 metastatic bone pain or serious osteoporosis cases, the symptoms were relieved by using 4mg of intravenous zoledronate every 45 days. Conclusion The ADT Could affect the quality of life with prostate cancer patient. Venlafaxine hydrochloride was effective for relieving the symptoms of hot flashes. Zoledronate could prevent and treat the ADT-releated Osteoporosis complications.