全雄激素阻断和全雄激素阻断结合^125I放射微粒植入治疗前列腺癌

目的：探讨全雄激素阻断和全雄激素阻断结合^125I放射微粒植入治疗前列腺癌的临床疗效。方法：收集我院近10年来中晚期前列腺癌病人44例，其中C期28例，D期16例。双侧睾丸切除 抗雄激素药物治疗(A组)35例，双侧睾丸切除 抗雄激素药物 ^125I放射微粒植入近距离放射治疗(B组)9例。比较治疗前后PSA的变化及生存率。结果：A组35例病人PSA平均值由60．3μg／L降至12．1μg／L。B组9例病人PSA平均值由72．1μg／L降至3．6μg／L。35例A组病人随访9～84(平均39．2)个月，排除非癌性死亡3例，因前列腺癌引起的死亡6例，生存率为81．3％(26／32)。B组9例病人随访7～24(平均13)个月，病人全部存活。结论：全雄激素阻断治疗及伞雄激素阻断治疗结合^125I放射微粒植入近距离放射治疗．是治疗中晚期前列腺癌的可供选择的有效方法。     

全雄激素阻断和全雄激素阻断结合125Ⅰ放射微粒植入治疗前列腺癌

目的:探讨全雄激素阻断和全雄激素阻断结合125Ⅰ放射微粒植入治疗前列腺癌的临床疗效.方法:收集我院近10年来中晚期前列腺癌病人44例,其中C期28例,D期16例.双侧睾丸切除+抗雄激素药物治疗(A组)35例,双侧睾丸切除+抗雄激素药物+125Ⅰ放射微粒植入近距离放射治疗(B组)9例.比较治疗前后PSA的变化及生存率.结果:A组35例病人PSA平均值由60.3μg/L降至12.1μg/L.B组9例病人PSA平均值由72.1μg/L降至3.6μg/L.35例A组病人随访9～84(平均39.2)个月,排除非癌性死亡3例,因前列腺癌引起的死亡6例,生存率为81.3%(26/32).B组9例病人随访7～24(平均13)个月,病人全部存活.结论:全雄激素阻断治疗及全雄激素阻断治疗结合125Ⅰ放射微粒植入近距离放射治疗,是治疗中晚期前列腺癌的可供选择的有效方法.     

全雄激素阻断和全雄激素阻断结合~(125)I放射微粒植入治疗前列腺癌

目的 :探讨全雄激素阻断和全雄激素阻断结合12 5I放射微粒植入治疗前列腺癌的临床疗效。　方法 :收集我院近 10年来中晚期前列腺癌病人 44例 ,其中C期 2 8例 ,D期 16例。双侧睾丸切除 +抗雄激素药物治疗 (A组 )35例 ,双侧睾丸切除 +抗雄激素药物 +12 5I放射微粒植入近距离放射治疗 (B组 ) 9例。比较治疗前后PSA的变化及生存率。　结果 :A组 35例病人PSA平均值由 6 0 .3μg/L降至12 .1μg/L。B组 9例病人PSA平均值由72 .1μg/L降至 3.6 μg/L。 35例A组病人随访 9～ 84(平均39.2 )个月 ,排除非癌性死亡 3例 ,因前列腺癌引起的死亡 6例 ,生存率为 81.3%(2 6 / 32 )。B组 9例病人随访 7～ 2 4(平均 13)个月 ,病人全部存活。　结论 :全雄激素阻断治疗及全雄激素阻断治疗结合12 5I放射微粒植入近距离放射治疗 ,是治疗中晚期前列腺癌的可供选择的有效方法。     

选择性绿激光汽化术联合全雄激素阻断治疗晚期前列腺癌

目的：探讨经尿道选择性绿激光汽化术（PVP）联合全雄激素阻断治疗晚期前列腺癌伴膀胱颈梗阻患者的临床疗效.方法：回顾性分析15例应用PVP联合全雄激素阻断治疗晚期前列腺癌伴膀胱颈梗阻患者的临床资料,观察患者手术时间、留置导尿管时间、术前后前列腺体积、国际前列腺症状评分（IPSS）、生活质量评分（QOL）、最大尿流率（Qmax）、剩余尿（PVR）及前列腺特异性抗原（PSA）的变化.结果：所有手术均成功,无输血及前列腺电切综合征现象.手术时间40～120 min,术后留置导尿管时间3～5天.术前前列腺体积、IPSS以及QOL分别为（95.13±16.36）ml、（19.87±4.10）分、（3.67±1.23）分.术后1个月分别为（48.47±11.55）ml、（12.27±3.24）分、（2.004±1.25）分（P均〈0.01） 术前Qmax、PVR分别为（8.05±2.51）ml/s、（136.47±32.16）ml,术后1个月分别为（18.40±4.63）ml/s、（33.87±13.44）ml（均P〈0.01） 术前PSA为（78.00±29.11）μg/L,术后1个月、3个月分别为（1.32±0.70）/μg/L、（0.48±0.07）μg/L（均P〈0.01）.结论：PVP联合全雄激素阻断治疗晚期前列腺癌伴膀胱颈梗阻是安全有效的,可以明显缓解患者的症状,抑制肿瘤进展,提高患者的生活质量.     

前列腺癌患者粒子植入治疗后血清PSA变化的观察

目的探讨前列腺癌患者粒子植入治疗后血清PSA变化规律.方法前列腺癌患者13例.临床分期：T1cN0M08例,T2aN0M05例;Gleason评分：5分4例,6分9例;血清PSA 2.8～14.6 ng/ml,平均8.2 ng/ml.采用125I粒子植入治疗,治疗剂量D90为140～155 Gy.术后定期复查血清PSA,观察其变化规律.结果13例患者随访3～23个月.术后1、2、3、6、9、12、15、18及21个月血清PSA中位值为6.7、5.0、2.7、1.6、1.2、0.9、0.8、0.8及0.7 ng/ml.分别为术前血清PSA中位数的72%、51%、29%、20%、13%、11%、9%、9%及8%.术后1个月30%患者血清PSA有波动.结论前列腺癌粒子植入治疗后患者血清PSA下降缓慢,早期有波动.术后1年尤其术后3个月内血清PSA下降相对较快.     

全雄激素阻断治疗抑制人前列腺癌前列腺干细胞抗原mRNA的表达

目的观察全雄激素阻断（CAA）治疗前后前列腺干细胞抗原（PSCA）mRNA 表达水平的变化,并进一步评估 PSCA 在人前列腺癌的临床预后价值。方法对42例男性患者的前列腺活检组织或经尿道前列腺切除组织（包括去势前局限性前列腺癌组织和前列腺癌根治术前接受比卡鲁胺和醋酸戈舍瑞林去势治疗3个月后的癌组织）进行原位杂交。PSCA mRNA 的肿瘤细胞质染色结果由两位病理学专家独立评估,t 检验分析 CAA 前后 PSCA mRNA 表达水平的差异。前列腺癌根治术后进行36~40个月的随访,旨在评估 PSCA mRNA 表达水平与癌症局部复发或转移的相关性。结果原位杂交标记 PSCA mRNA 阳性的细胞由 CAA 前的67.3%（0~89%）±9.4%下降到 CAA 后33.8%（0~92%）±7.7%（P 〈0.001）。CAA 前95.2%（40/42）的患者 PSCA mRNA 表达阳性,而去势后阳性率降到67.5%（27/40）,且随访未发现有局部复发或远处转移。PSCA mRNA 阳性表达的减少取决于原始肿瘤的 Gleason 评分,Gleason≤6：19.3%±4.7%;Gleason=7：38.8%±7.2%;Gleason≥8：73.4%±13.8%（P 〈0.05）。其余13例,CAA 后 PSCA mRNA 阳性表达水平增加,且随访发现3例有局限复发,4例有远处转移。结论前列腺癌 CAA 可抑制 PSCA mRNA 的表达;去势治疗后 PSCA mRNA 表达的增加可成为肿瘤复发或远处转移的一个不利预测指标。     

前列腺癌近距离治疗的效果和不良反应分析

目的探讨局限性前列腺癌患者接受近距离治疗的疗效及不良反应。方法2001～2010年接受近距离治疗的局限性前列腺癌患者67例。随访术后PSA变化及不良反应发生情况,并分析影响治疗效果的相关因素。结果64例（95．5％）获得平均33．9（4～112）个月的随访。术前PSA平均为20．04ng／mL,术后最低PSA值平均为1．15ng／mL,40例（62．5％）患者最低PSA值〈1ng／mL,26例（40．6％）患者最低PSA值〈0．5ng／mL,达最低PSA值时间平均为术后11（1～26）个月。术后常见短期不良反应有：发热4例,血尿8例,便血3例。长期不良反应有：尿路刺激症状19例,便血7例,血尿2例,尿失禁2例,尿潴留1例。结论近距离治疗是局限性前列腺癌的有效治疗方法,疗效肯定,并发症发生率低,严重不良反应少见。     

125Ⅰ粒子植入联合全雄激素阻断治疗初诊寡转移性前列腺癌的疗效分析

目的:探讨~(125)I粒子前列腺组织间植入近距离放射治疗(BT)联合全雄激素阻断(CAB)临床用于治疗初诊寡转移性前列腺癌患者的有效性。方法:回顾性分析2009年1月～2016年1月收治的77例寡转移性前列腺癌患者的治疗及随访资料。其中BT+CAB治疗组40例,单纯CAB治疗组37例。两组患者中位随访时间均为49个月。随访期间每月监测血清PSA及睾酮水平,记录PSA最低值及到达最低值的时间。每6个月行盆腔MR及ECT全身骨扫描检查,记录疾病出现进展的时间。Kaplan-Meier法分别绘制两组患者的疾病无进展生存曲线和总生存曲线,并进行生存比较。对可能影响BT+CAB治疗组患者疾病进展的临床病理指标进一步行多因素分析。结果:BT+CAB治疗组和CAB治疗组患者的PSA最低值分别为(0.31±0.43)ng/ml和(0.57±0.72)ng/ml,两组差异无统计学意义(P0.05)。BT+CAB治疗组患者PSA达到最低值的时间明显要长于CAB治疗组[(7.38±1.60)个月vs.(6.73±1.15)个月,P0.05]。两组患者的5年总生存率分别为71.63%和58.11%,但Log-rank检验显示两组总体生存曲线比较差异无统计学意义(P0.05)。BT+CAB治疗组患者的无进展生存状况明显优于CAB治疗组(P0.05),两组的中位无进展生存期分别为41个月和33个月,3年无进展生存率分别为58.04%和35.51%。Cox多因素分析显示Gleason评分和PSA最低值是BT+CAB治疗组患者发生疾病进展的独立预测因子。结论:与单纯CAB治疗相比,BT+CAB治疗可以明显延缓初诊寡转移性前列腺癌患者的疾病进展,并取得一定的生存获益,这种联合治疗方法是安全有效的。Gleason评分(≥8分)和PSA最低值(≥0.4ng/ml)是寡转移性前列腺癌患者接受BT+CAB联合治疗后疾病进展的独立风险因素。     

前列腺特异性抗原倍增时间在前列腺癌最大限度雄激素阻断治疗后随访中的价值

目的 探讨前列腺特异性抗原倍增时间(prostate-specific antigen doubling time,PSADT)在前列腺癌患者最大限度雄激素阻断(maximal androgen blockade,MAB)治疗后判断病情进展及预后中的价值.方法 回顾性分析1994年1月至2010年12月接受MAB治疗的159例前列腺癌患者的临床资料.年龄54～90岁,平均74岁.治疗前血PSA 2.6～ 275.0 μg/L,中位数为46.8 μg/L.Gleason评分≤6分、7分及≥8分者分别为44、67、40例,不详8例.临床分期T1NoM0、T2N0M0期共42例,T3N0M0期18例,T4N0M0、T0N1M0、T0N0M1期92例,不详7例.计算患者PSADT并进行生存率分析,采用Cox比例风险模型多因素分析PSADT对预后的影响,并分析疾病进展情况.结果 159例随访6～126个月,平均28个月.PSADT为0.5 ～21.0个月,中位数为5.7个月.其中PSADT≥6个月71例,3年和5年生存率分别为89.4％和47.6％;PSADT＜6个月88例,3年和5年生存率分别为49.8％和30.6％,两组生存率比较差异有统计学意义(P＜0.05).Cox比例风险模型多因素分析证实PSADT是影响前列腺癌患者预后的主要因素之一,其相对危险度为2.646(P＜0.05).PSADT≥6个月组中随访期间病情发生进展14例(19.7％),PSADT＜6个月组为56例(63.6％),两组比较差异有统计学意义(P＜0.05).结论 PSADT能提示接受MAB治疗的前列腺癌患者的预后,PSADT≥6个月患者的生存率高于PSADT＜6个月患者.PSADT可用于预测前列腺癌患者接受MAB治疗后的疾病进展情况.     

晚期前列腺癌联合雄激素阻断治疗的长期随访

目的:了解晚期前列腺癌联合雄激素阻断治疗的长期生存率。方法:选取1993年1月~2000年1月初采用联合雄激素阻断治疗的59例前列腺腺癌患者,其中28.81%和45.76%为临床局部晚期(T3-4 N0M0期)和转移(TxNxM+期)病例,全部随访5年以上。结果:全组病例3、5、7年的总体生存率分别是79.36%、61.46%、49.15%,其中,临床局部晚期和转移者的5年生存率分别为80.77%和32.65%,而高分化腺癌和低分化腺癌的5年生存率分别为86.21%和30%(P<0.01)。另外,PSA>30μg/L时其长期生存率有明显下降趋势。结论:采用内分泌治疗的晚期前列腺癌,病理低分化、临床分期达T3 c-4NxMx或TxNxM+期及PSA>30μg/L均提示预后较差,晚期前列腺癌病例的治疗应综合多因素,选择个体化方案。     

Commentary on maximal androgen blockade in prostate cancer: A theory to put into practice?

The population at risk of prostate cancer is on the increase, and so is public awareness of this disease. There has been an unresolved controversy surrounding the benefits of maximal androgen blockade (MAB) as a valid approach to treatment of non-curative prostate cancer since it was first proposed in 1945. How are we to interpret the data on MAB in order to give each patient the best advice on treatment? Studies of MAB using medical castration (luteinizing hormone-releasing hormone [LHRH] analogue plus antiandrogen) vs. LHRH analogues alone are inconclusive when viewed collectively, although the largest showed objective benefits for MAB. The remaining studies have insufficient power to show the expected effect size. Studies of MAB using surgical castration plus antiandrogen vs. surgical castration alone also gave inconsistent results, although a meta-analysis is in favor of MAB on objective criteria of response. Among trials of MAB using an LHRH analogue vs. surgical castration alone, one is positive and the remaining two are neutral for MAB. No study shows MAB to be worse than either medical or surgical castration alone. An overall meta-analysis shows a trend for benefit with MAB but is not statistically significant. The existing data have strongly suggested that there may be a particular benefit for certain subgroups of patients (including those with minimal disease) but numbers studied have been too small to allow valid conclusions. The INT 0105 trial in progress may permit firmer conclusions to be drawn on this and other questions. In the meantime one of the drawbacks to current MAB regimens is the exchange of modest clinical advantages for the side effects of nilutamide and flutamide. Given that the disease is noncurative, improved quality of life is the main goal of therapy, and excellent tolerability of treatment is fundamental to this. In a comparative trial, bicalutamide (Casodex) was more effective than flutamide (each in combination with an LHRH analogue) in terms of time to treatment failure and produced a significantly lower incidence of diarrhoea. In conclusion, the evidence supports early use of adequate hormonal treatment, and this should mean either medical or surgical castration, ideally augmented by an antiandrogen. Tolerability of the antiandrogen is a key consideration in gaining an improvement in quality of life with MAB. © 1995 Wiley-Liss, Inc.     

Deferred combined androgen blockade therapy using bicalutamide in patients with hormone-refractory prostate cancer during androgen deprivation monotherapy

OBJECTIVE: To assess the effect of adding bicalutamide on serum prostate-specific antigen (PSA) levels in patients with hormone-refractory prostate cancer (HRPC) during androgen deprivation monotherapy (ADMT). PATIENTS AND METHODS: Forty-four patients with HRPC were treated with deferred combined androgen blockade (CAB) therapy, administering bicalutamide 80 mg once daily. HRPC was defined biochemically as three consecutive rises in PSA level during ADMT. The treatment response was defined as a > or = 50% decline in PSA levels. Prognostic values of various pretreatment variables for responsiveness to deferred CAB were determined statistically. When the disease relapsed during deferred CAB, bicalutamide was discontinued and the patients were evaluated for the antiandrogen withdrawal syndrome (AWS). RESULTS: Of the 44 patients, 29 (66%) had a PSA response; the median PSA failure-free survival was 9.2+ months. Biopsy Gleason score was the only pretreatment variable predictive of a PSA response (mean Gleason score 7.9 in responders and 8.7 in nonresponders). The PSA doubling time (PSA-DT) was the only statistically significant variable of PSA failure-free survival in a multivariate analysis. The 1- and 2-year PSA failure-free survival rates were 43% and 31% in patients with a PSA-DT of >4 months, while it was 21% and none, respectively, in those with a PSA-DT of <4 months. Responders to deferred CAB had a statistically longer cancer-specific survival than nonresponders. None of 20 patients who were evaluated for AWS had the condition. CONCLUSIONS: Deferred CAB therapy using bicalutamide is effective in patients with progression during ADMT, particularly in those with lower Gleason score tumours or a longer PSA-DT. AWS after deferred CAB is uncommon.     

Why phase III trials of maximal androgen blockade versus castration in M1 prostate cancer rarely show statistically significant differences

BACKGROUND: The meta-analysis of maximal androgen blockade (MAB) concluded that there is no survival advantage of MAB over castration alone. However, the results from the largest trials yield conflicting results. METHODS: The design and results of three trials were examined. RESULTS: Most studies were planned to detect an over-optimistic difference in survival and immature data were published. The survival curves show that statistical assumptions are not fulfilled. Excluding from the meta-analysis all trials where a negative impact of disease flare on survival could not be excluded resulted in no difference in survival between MAB and castration. CONCLUSIONS: Trials of MAB should be planned to detect differences of no more than 5-10% in median survival. The analyses should only be carried out on mature data and should take into account the possibility of a negative impact on survival due to disease flare if no anti-androgen has been given initially with an LH-RH agonist.     

Signet-ring cell carcinoma of the prostate effectively treated with maximal androgen blockade

Primary signet-ring cell carcinoma (SRCC) of the prostate is very rare and has a poor prognosis, even when treated with aggressive therapy. We report herein a case of a 72-year-old man with prostatic SRCC. The patient had a tumor that extended directly to the rectum. Maximal androgen blockade was started and 20 months later, the patient was alive without evidence of recurrence. The present case of prostatic SRCC responded well to medical therapy, however, tumors can recur after a long period of time. Therefore, adjuvant therapy is recommended.     

A re-assessment of the role of combined androgen blockade for advanced prostate cancer

Combined androgen blockade is a controversial topic, which has arguments both for and against. It is revisited by the authors of this mini‐review, with a full discussion on the benefits and cautions with this approach. A wide range of other issues is also addressed in this section: bilateral testicular cancer, male‐factor infertility, and buccal mucosa urethroplasty. All of these are of interest to general urologists, as well as to those with a more specific area of interest.     

Effects of combined androgen blockade on bone metabolism and density in men with locally advanced prostate cancer

Objective: To investigate whether combined androgen blockade (CAB) produces any adverse effects on bone metabolism and mineral density in patients with locally advanced prostate cancer.Materials and methods: The study group consisted of 17 stage T4 prostate cancer patients treated with CAB and had no evidence of bone metastasis on bone scintigraphy. The mean duration of CAB and final total prostate specific antigen (PSA) level at the time of study were found at 28.5 ± 15.9 (6–58) months and 0.39 ± 0.5 (0.1–2) ngml, respectively. Twenty age and socioeconomically matched benign prostate hyperplasia (BPH) patients were taken as the control group. Both groups were compared with regard to lumbar bone mineral density (LBD), femur bone mineral density (FBD) and serum parameters of bone metabolism namely calcium (Ca), phosphate (P), magnesium (Mg) and alkaline phosphatase (ALP). Bone mineral density was measured with dual energy x-ray absorptiometry.Results: The mean FBD, LBD and serum Ca, P, Mg and ALP measurement of the patients treated with CAB were 0.85 ± 0.1 g/cm², 1.16 ± 0.2 g/cm², 9.1 ± 0.3 mg/dl, 3.6 ± 0.6 mg/dl, 1.95 ± 0.14 mg/dl, 187.5 ± 61 mg/dl, respectively. No significant difference was found between patients subjected to CAB and the age matched controls in any of the studied parameters namely age, FBD, LBD, Ca, Mg and ALP except serum phosphate. Serum phosphate levels were significantly (p =0.001) higher in patients treated with CAB suggesting a minor effect of CAB on bone metabolism.Conclusion: No convincing evidence was found about the detrimental effect of CAB on bone mineral density and metabolism in a highly selected group of patients with advanced prostate cancer without bone metastases.     

Combined androgen blockade in the management of advanced prostate cancer: A sensible or ostensible approach

BACKGROUND: To compare the efficacy of orchiectomy alone and orchiectomy plus flutamide in treating patients with advanced carcinoma prostate. MATERIALS AND METHODS: The study was initiated on 1 July 1997 and closed after enrolling 100 patients on 30 June 2000. Patients were prospectively randomized to orchiectomy alone (O) and orchiectomy plus flutamide (OF). A complete response (CR) was defined as the normalization of bone scans and serum prostate-specific antigen (PSA) levels returning to normal (< 4 ng/mL). A partial response (PR) was defined as a 50% reduction in metastasis mass compared to the initial study or a decrease in the PSA level of 50% of the initial value. Progressive disease (PD) was defined as the development of any new hot spot on bone scan or any increase in previously existing PSA level by 25%. RESULTS: A total of 100 patients were entered in the study. The maximum percentage change in PSA levels in both groups was found in the first 3 months after orchiectomy, that is, 95% and 97% for the O and OF groups, respectively. In more than 80% of the patients this decrease in PSA was maintained for 3 years. The mean percentage change at 3 years in the O and OF groups was 70% and 75% (P = 0.95), respectively, and the overall response rate (CR + PR) was 88.50% and 86.53% in the two groups, respectively (P = 0.85). The follow-up period ranged between 3 and 5 years (mean, 3.5 years). The mean time to progression was 27 and 29 months in the O and OF groups, respectively. The overall survival rate at 3 and 5 years in two treatment groups was 45.83% and 48.07%, 20.83% and 23.07% in the O and OF groups, respectively (P = 0.75). CONCLUSIONS: Maximum percentage decrease in PSA is seen within the first 3 months of therapy. Orchiectomy alone is as effective as combination therapy in decreasing serum PSA. Overall survival at 3 and 5 years in the orchiectomy only group was as good as that of combination therapy. These data suggest that the routine addition of flutamide to orchiectomy is not advisable.     

Clinical outcome of maximum androgen blockade using flutamide as second-line hormonal therapy for hormone-refractory prostate cancer

OBJECTIVES: To investigate the efficacy of maximum androgen blockade (MAB) using flutamide as second-line hormonal therapy for advanced hormone-refractory prostate cancer (HRPC). PATIENTS AND METHODS: The study included 55 patients with HRPC who were treated with MAB using flutamide (375 mg daily) as second-line hormonal therapy. All patients had previously received bicalutamide combined with either surgical or medical castration as first-line hormonal therapy, which failed. The effect of the second-line therapy was evaluated by serum prostate-specific antigen (PSA) level alone, and the response defined as a decrease of >50% from the baseline PSA at the start of second-line therapy. RESULTS: On initiating second-line hormonal therapy there was a reduction in the PSA level in 25 of the 55 patients (45%), among whom 12 (22%) were regarded as responders, while the PSA level continued to increase in the remaining 30 (55%). The median (range) duration of the PSA response was 6 (1-13) months. During the observation period there were no severe side-effects from the second-line MAB therapy. Patients without bone metastases or whose disease progressed >1 year after first-line therapy had a significantly higher incidence of PSA response to second-line therapy, despite no significant effect of other factors examined on the PSA response to second-line therapy. Furthermore, the cause-specific survival in responders to second-line therapy was significantly better than that in nonresponders; however, multivariate analysis showed that no factors, including response to second-line therapy, could be used as independent predictors of cause-specific survival. CONCLUSIONS: MAB using flutamide as second-line hormonal therapy can give a comparatively favourable PSA response with no severe side-effects; therefore, this therapy may be suitable for patients with HRPC after primary MAB using bicalutamide has failed, particularly in those with no bone metastases or whose disease has progressed for >1 year after first-line therapy.     

晚期前列腺癌内分泌治疗后血清PSA、f-PSA含量的变化

目的探讨前列腺癌(PCa)患内分泌治疗后前列腺特异抗原(PSA)、游离前列腺特异抗原与总前列腺特异抗原比值(f／tPSA)变化的临床意义。方珐测定PCa患内分泌治疗前及治疗后1、3、6个月血清PSA、游离前列腺特异抗原(f-PSA)变化。砖杲治疗后1个月与治疗前相比血清PSA下降明显，治疗后6个月较治疗后1个月血清PSA下降亦有显意义；治疗后患血清f-PSA水平明显下降。f／tPSA值的变化无显意义。结论血清PSA、f-PSA可作为判断PCa内分泌治疗效果的标准．如血清PSA、f-PSA复又升高提示肿瘤复发。