比卡鲁胺联合戈舍瑞林间断性治疗前列腺癌临床研究

目的:观察比卡鲁胺联合戈舍瑞林间断性治疗对前列腺癌患者血清PSA、f-PSA的影响，及对排尿梗阻症状、骨转移灶和骨痛感的疗效。方法:将本院2005年7月-2012年7月收治的前列腺癌患者84例分为手术去势组20例，持续药物去势组32例和间歇药物去势组32例。手术去势组病例行双侧睾丸切除术，并口服比卡鲁胺治疗，持续药物去势组予比卡鲁胺合戈舍瑞林治疗，间歇药物去势组给药同持续药物去势组，当患者血清PSA值降至0.2ng/ml以下时停止给药，PSA值重新升至4ng/ml以上时，再给药治疗。分别在治疗前、治疗后1、3、6、12个月时观察三组患者的血清PSA、f-PSA变化，及有排尿梗阻症状、骨转移灶和骨痛感患者的变化。结果:三组患者治疗后血清PSA、f-PSA值较本组治疗前均有明显下降（P＜0.01）。三组治疗后血清PSA、f-PSA值同时间组间比较无显著差异（P＞0.05）。三组治疗后有自觉排尿梗阻症状、有骨转移灶及有骨痛感的患者数较本组治疗前均有明显减少（P＜0.05）。结论:比卡鲁胺联合戈舍瑞林间断性疗法对前列腺癌的控制治疗可与持续疗法和手术去势疗法收到同样疗效。

Clinical study on intermittent treatment of prostate cancer with bicalutamide and goserelin

Objective:To observe the influence of intermittent treatment with bicalutamide and goserelin on prostate cancer patients' serum levels of PSA and f-PSA and its efficacy on metastasis，urinary obstruction and bone pain.Methods:In our hospital from July 2005 to July 2012，84 cases of prostate cancer were divided into operation group（20 cases）,continuous drug therapy group（32 cases）and intermittent drug therapy group（32 cases）.Operation group patients were treated with bilateral orchiectomy,and given bicalutamide orally.The continuous drug group was given bicalutamide and goserelin.The intermittent drug group was administered with bicalutamide and goserelin intermittently and when serum PSA level was less than 0.2ng/ml the administration would be stopped while when the PSA more than 4ng/ml，the drugs would be given again.Before and 1,3,6,12 month after treatment，three groups' serum PSA and f-PSA levels changes were observed and the urination obstruction symptoms,bone metastases and bone pain feelings of the patients were also observed.Results:After treatment,serum PSA and f-PSA levels in three groups were all significantly decreased than those before treatment (P＜0.01).There was no significant difference among the three groups (P＞0.05).In three groups self-conscious urinary obstruction,bone metastasis and the number of patients with bone pain were significantly reduced than those before treatment (P＜0.05).Conclusion:Bicalutamide and goserelin intermittent therapy in treatment of prostate cancer with continued therapy and operation have the same effect of castration.