间歇内分泌治疗联合调强适形放射治疗局限性前列腺癌的临床研究

目的：探讨间歇性内分泌治疗联合调强适形放射治疗局限性前列腺癌的临床价值。方法：选择局限性前列腺癌患者72例，分为两组，联合治疗组37例，采用间歇内分泌治疗联合调强适形放射治疗；单纯治疗组35例，采用单纯调强适形放射治疗。分析比较两组患者的临床症状缓解率、前列腺体积变化情况、血清前列腺特异抗原（PSA）值改变、肿瘤控制率、放疗不良反应发生率及生存率等方面。结果：随访5～118个月，平均56个月。联合治疗组与单纯治疗组比较，临床症状缓解率差异有统计学意义（x^2=3．280，P=0．036）；前列腺体积差值的差异有统计学意义（t=5．1353，P=0．000）；血清PsA〈0．2μg／L者所占比例差异有统计学意义（x^2=20．182，P=0．000）；1年、3年、5年和8年PSA无进展生存率差异均有统计学意义（P〈0．05）；1年、3年均无死亡病例，差异均无统计学意义；5年生存率差异有统计学意义（x^2=5．168，P=0．023）；8年生存率差异有统计学意义（x^2=5．061，P=0．024）；早期放疗不良反应发生率差异有统计学意义（P〈0．05）。结论：间歇内分泌治疗联合调强适形放射治疗局限性前列腺癌可明显改善患者的临床症状，降低血清PSA水平，提高疾病控制率及患者生存率，降低放疗早期不良反应发生率，疗效优于单纯调强适形放射治疗，是一种安全、有效的治疗措施。

Clinical therapeutic effect of the combining of intermittent endocrine therapy and intensity modulated conformal radiation therapy in treating localized prostate cancer

Objective： To investigate the clinical therapeutic effect of the combining of intermittent endocrine therapy and intensity modulated conformal radiation therapy in treating localized prostate cancer. Method： Thirty seven patients with locally advanced prostate cancer were treated with endocrine therapy （maximum androgen blockade） combined with radiotherapy （intensity modulated conformal radiotherapy） . Another 35 patients of the same period with locally advanced prostate cancer were only treated with radiotherapy （intensity modulated confor mal radiation therapy） . Clinical remission rate, prostate volume, serum PSA, tumor control rate, adverse effects incidence and survival rate of the two groups were analyzed and compared. Result： All the patients were followed up for 5 to 118 months. The mean period was 56 months. The clinical remission rate of combined treatment group showed statistically significant difference compared with that of the simple radiotherapy treatment group （x^2 =3. 280, P= 0. 036） . The prostate volume of the two groups showed statistically significant difference （t= 5. 1353, P = 0. 000）. The proportion of serum PSA〈0.2 μg/L of the two groups after treatment showed statistically significant difference （x^2= 20. 182, P= 0. 000） . The PSA-free survival rate of the two groups in 1, 3, 5, 8 years showed statistically significant difference （P〈0.05） . There was no death in 1 and 3 years and it showed no statistically significant difference. The survival rate of the two groups in 5 and 8 years showed statistically significant difference （x^2=5.168, P=0.023 and ）22= 5. 061, P=0.024） . The adverse effects incidence of the two groups showed statistically significant difference （P〈0.05）. Conclusion：Intermittent endocrine therapy combined with ra diotherapy can effectively relieve clinical symptoms of patients with locally advanced prostate cancer, and it can al so reduce serum PSA level, improve tumor control rate and survival rate without adverse effects. The combined treatment is more effective and safer than simple radiotherapy.