激素抵抗性前列腺癌(附39例报告)

目的探讨激素抵抗性前列腺癌的诊断和治疗,以提高其诊治水平。同时比较中国人和欧美人激素抵抗性前列腺癌生存期的差异。方法回顾性分析1995年6月～2004年10月39例激素抵抗性前列腺癌患者的临床资料。结果确诊激素抵抗性前列腺癌时,38例血PSA值较最低点均有不同程度升高,血PSA值0．2ng/ml～200ng/ml,平均(51．16±54．71)ng/ml,其中有4例血PSA值一直在4ng/ml以下,升高很少,主要靠转移灶来诊断。化疗是主要的治疗方法,常用的有磷酸雌二醇氮芥,磷酸雌二醇氮芥 足叶乙甙,环磷酰胺 足叶乙甙,磷酸雌二醇氮芥 环磷酰胺等。PSA有效率为44．4%～57．8%,平均有效时间3,8月～7．5月,软组织灶有效率为28．6%～50%。39例中已死亡21例,这21例诊断激素抵抗性前列腺癌后,中位生存期为16个月。结论绝大多数激素抵抗性前列腺癌患者可用PSA诊断和随访,但极少数患者PSA变化很小,需用癌灶和症状来随访。化疗是治疗激素抵抗性前列腺癌的主要方法,有一定的疗效。本组患者生存时间似较欧美患者长。

Hormone refractory prostate cancer (report of 39 cases)

Objective To study diagnosis and treatment of hormone refractory prostate cancer and to improve the recognization of the disease.To find survival difference between patients from China and west countries.Methods The clinical data of 39 cases from Jane 1995 to October 2004 were retrospectively analysed.Results Serum PSA level of 38 patients were stepped-up from lowest when hormone refractory prostate cancer was diagnosed.But in four patients PSA level were always under 4ng/ml,diagnosis of HRPC of these patients relied on the appearance or enlargement of metastatic focus. Oral chemotherapy regimen using estramustine phosphate,etopside and cyclophosphamide were mainly treatment of hormone refractory prostate cancer patients in our group.PSA efficiency rate was range from 44.4% to 57.8%,and average effective time was range from 3.8 months to 7.5 months.Objective response rate was ranged from 28.6% to 50%.21 cases were died,and medial duration of life was 16 months.Conclusion Almost all HRPC patients can be diagnosis and follow up by serum PSA. Chemotherapy was the major therapy for treating HRPC.Oral combination regimen with two drugs have nice effect.Medial survival time of HRPC patients from China maybe longer than those from west world.