全雄激素阻断与全雄激素阻断结合^125I放射性粒子植入治疗中晚期前列腺癌的疗效比较

目的：比较全雄激素阻断（双侧睾丸切除＋抗雄激素药物）与全雄激素阻断结合^125I放射性粒子植入治疗中晚期前列腺癌的临床疗效，探讨治疗中晚期前列腺癌的有效方法。方法：中晚期前列腺癌患者40例，其中12例应用全雄激素阻断治疗（A组），28例应用全雄激素阻断结合^125I放射性粒子植入近距离放射治疗（B组）。比较治疗前后前列腺特异性抗原的变化及术后3年生存率。结果：术后1个月2组前列腺特异性抗原均快速下降，2组比较差异无统计学意义（P〉0．05）；术后6个月，B组前列腺特异性抗原明显低于A组，差异有统计学意义（P〈0．05）；2组术后3年生存率差异有统计学意义（P〈0．05）。结论：全雄激素阻断治疗及全雄激素阻断结合^125I放射微粒植入近距离放射治疗，均是治疗中晚期前列腺癌的有效方法，而后者疗效更加肯定。

Comparison of total androgen blockade and total androgen blockade combined with ^125I brachytherapy in middle and later period prostate cancer

Objective To investigate the therapeutic efficacy of total androgen blockade （bilateral orchidectomy and anti androgen drugs ） and total androgen blockade combined with ^125I brachytherapy in middle and later period prostate cancer. Methods Forty patients with prostate cancer in recent 5 years were analyzed retrospectively. Twelve of them were treated with total androgen blockade （group A）, and 28 treated with total androgen blockade combined with ^125I brachytherapy （group B）. The 3-year survival rate and the changes of serum prostate-specific antigen levels between pre- and post-treatment were compared. Results The level of prostate-specific antigen decreased rapidly both in group A and in group B one month after operation. But there was no statistic difference between the two groups（P〉0.05）. However, the level of prostate-specific antigen 6 months after operation in group A was quite different from that in group B （P〈0.05）. The difference of 3-year survival rate between the two groups had a statistic difference（P〈0.05）. Conclusion Total androgen blockade and total androgen blockade combined with ^125I brachytherapy are both effective for patients with middle period and advanced prostate cancer, and the latter one is more effective.