中晚期前列腺癌临床治疗分析

目的 :探讨放疗、内分泌治疗和联合治疗对前列腺癌的临床疗效及PSA的临床诊断价值。　方法 :回顾总结 1986～ 1997年 5 0例C期以上前列腺癌临床治疗资料 ,比较不同治疗方法的客观生存率及PSA在治疗前后的变化。　结果 :治疗前 93 .7%病人PSA >4μg/L ,内分泌治疗后PSA水平下降 80 %～ 86 % ;80 %肿瘤发展病人PSA升高 1倍以上。手术去势组C期病人 2年和 5年生存率为 10 0 %和 6 6 % ;D期为 82 %和 36 %。放疗组C、D期 2年和 5年生存率分别为 10 0 %、5 0 %和 5 0 %、0。放疗联合去势术治疗C期病人 2年和 5年生存率为 10 0 %和 77%。药物治疗组 2年生存率为 90 %。　结论 :PSA是诊断前列腺癌及评价治疗预后的敏感指标。放疗联合内分泌治疗是C期前列腺癌的有效治疗方法 ,内分泌治疗D期前列腺癌优于放疗

Clinical Analysis on the Treatment of Prostate Cancer

Objectives: To investigate the effect of radiation therapy,hormonal therapy,and to combinations of these modalities on local advanced and metastatic prostatecancer,and to evaluate the diagnostic value of PSA. Methods: Fifty patients withprostate cancer up stage C (from 1986 to 1997) were studied retrospectively.According to the different treatment, these cases were divided into 4 groups,and thesurvival rates among these groups and the variation of serum PSA levels between pre-and post-therapeutics were compared. Results: The PSA of >93.7% patients was >4μg/Land the serum level decreased 80%～86% after endocrinology therapy(P<0.05).The 2-and 5- year survival rates for stage C patients after surgical ablation were 100%and 66%, while those for stage D were 81% and 36%. In the group of radiation, thesurvival rates were 100%,50% for stage C and 50%,0 for stage D. In the group ofcombined treatment,2-year survival rate is 100%,and 5-year was 77%. Conclusions: PSAis a sensitive marker for diagnosis and prognosis of prostate cancer.Radiationcombined hormonal therapy is more effective than any single treatment. For stage D,hormonal therapy is better than radiation. Natl J Androl,2001,7(2):90～93