比卡鲁胺治疗中晚期前列腺癌的疗效及安全性分析

目的：评价并探讨比卡鲁胺（Bicalutamide capsules）治疗中晚期前列腺癌的临床疗效及治疗的安全性。方法：2005年6月1日～2008年5月31日,我院收治前列腺癌患者42例,年龄58～86岁,平均72岁。均经前列腺穿刺活检证实为腺癌。血清PSA值2.6～168.2ng·mL^-1,Gleason评分2～4分6例,5～7分28例,8～10分8例。采用手术去势加雄激素阻断比卡鲁胺（岩列舒）50mg]的30例,药物去势戈舍瑞林3.6mg·（28d）^-1]加雄激素阻断（比卡鲁胺50mg·d^-1）12例,连续治疗12个月,之后根据PSA水平采用间歇治疗。随访症状改善情况、肿瘤消退情况、肝肾功能、血PSA值及生存时间。结果：42例治疗后,开始PSA均有下降,随访第1年时,37例血PSA降至正常,第2年,33例病情稳定,6例下降不满意或出现反跳,改用其他治疗方式。到目前为止,36例存活,其余3例死于前列腺癌进展,3例死于其他疾病。结论：内分泌治疗是中晚期前列腺癌的主要治疗方法,可明显改善症状,控制疾病进展,延长生存时间,且不良反应轻微。

Efficacy and Safety of Bicalutamide for Intermediate or Advanced Prostate Cancer

OBJECTIVE： To evaluate the clinical efficacy and safety of Yanlie Shu （Bicalutamide Capsules） for intermediate or advanced prostate cancer. METHODS： 42 patients （aged between 58 to 86 years,with a mean of 72 years） with prostate cancer admitted to our hospital between June 1,2005 and May 31,2008 were enrolled. All were confirmed as having adenocarcinoma by prostate biopsy. Serum PSA level was from 2. 6 ng·mL^ -1 to 168. 2 ng· mL^ -1; 6 cases has Gleason score of 2 ～4 points; 28 cases had Gleason sores of 5 ～7 points,and 8 cases had Gleason sores of 8 ～10 points. 30 cases were given surgical castration and androgen blockade （Yanlie Shu 50 mg·d ^-1） and 12 cases were given medical castration Zoladex 3. 6 mg·（28 d） ^-1]plus androgen blockade （Yanlie Shu 50 mg· d ^-1）. After treatment for 12 months,intermittent treatment was applied based on PSA levels. Improvement in symptoms,tumor regression,function of liver and kidney,serum PSA level and survival time were followed. RESULTS： Serum PSA level in all 42 cases began to decline after treatment. At follow - up of one year,serum PSA level in 37 patients had decreased to normal; at the second year,33 patients’ condition was stable,but serum PSA level in 6 cases showed an unsatisfied decrease or bounced,so these patients were shifted to be treated with other therapy. So far,36 patients survived; 3 patients died of prostate cancer progress,and 3 cases died of other diseases. CONCLUSION： Endocrine therapy is the main remedy for intermediate or advanced prostate cancer in that it can significantly improve patients’symptoms,delay disease progression,and prolong patients’ survival time yet with mild adverse reactions.