全雄激素阻断和全雄激素阻断结合^125I放射微粒植入治疗前列腺癌

目的：探讨全雄激素阻断和全雄激素阻断结合^125I放射微粒植入治疗前列腺癌的临床疗效。方法：收集我院近10年来中晚期前列腺癌病人44例，其中C期28例，D期16例。双侧睾丸切除 抗雄激素药物治疗(A组)35例，双侧睾丸切除 抗雄激素药物 ^125I放射微粒植入近距离放射治疗(B组)9例。比较治疗前后PSA的变化及生存率。结果：A组35例病人PSA平均值由60．3μg／L降至12．1μg／L。B组9例病人PSA平均值由72．1μg／L降至3．6μg／L。35例A组病人随访9～84(平均39．2)个月，排除非癌性死亡3例，因前列腺癌引起的死亡6例，生存率为81．3％(26／32)。B组9例病人随访7～24(平均13)个月，病人全部存活。结论：全雄激素阻断治疗及伞雄激素阻断治疗结合^125I放射微粒植入近距离放射治疗．是治疗中晚期前列腺癌的可供选择的有效方法。

Maximal androgen blockade and maximal androgen blockade combined with 125I brachytherapy for prostatic cancer]

OBJECTIVE: To assess the effect of the maximal androgen blockade(MAB) and MAB combined with 125I brachytherapy on prostatic cancer. METHODS: Forty-four patients with prostatic cancer (from 1993 to 2002), 28 at pathologic stage C and 16 at stage D, were analyzed retrospectively. Thirty-five of them were treated by bilateral orchidectomy and anti-androgen drugs, i.e. MAB, and 9 treated by MAB combined with 125I brachytherapy. The survival rates and the variation of serum prostate-specific antigen (PSA) levels between pre- and post-treatment were compared. RESULTS: The level of PSA decreased from 60.3 micrograms/L to 12.1 micrograms/L in 35 patients treated by MAB, and from 72.1 micrograms/L to 3.6 micrograms/L in 9 patients treated by MAB combined with 125I brachytherapy after 6 months. The post-treatment survival rates were 81.3% (26/32, excluding 3 deaths by other diseases) for patients treated by MAB after a mean follow-up of 39.2 (9-84) months and 100% for patients by MAB combined with 125I brachytherapy after a mean follow-up of 13(7-24) months. CONCLUSION: MAB and MAB combined with 125I brachytherapy are effective for patients with prostatic cancer.