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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。
Objective To investigate the diagnosis and treatment of hormone-resistant prostate cancer in order to improve its diagnosis and treatment. At the same time, we compared the differences in the survival of hormone-refractory prostate cancer between Chinese and Europeans. Methods The clinical data of 39 patients with hormone-refractory prostate cancer from June 1995 to October 2004 were retrospectively analyzed. Results When steroid-resistant prostate cancer was diagnosed, the serum PSA levels of 38 patients were all elevated to some extent compared with the lowest point. The blood PSA level was 0.2ng / ml ~ 200ng / ml, with an average of (51.16 ± 54.71) ng / ml , Of which 4 cases of blood PSA value has been below 4ng / ml, rarely increased, mainly by the diagnosis of metastases. Chemotherapy is the main method of treatment, commonly used are estramustine phosphate mustard, estramustine phosphate + etoposide, cyclophosphamide + etoposide, estramustine phosphate + cyclophosphamide. PSA effective rate was 44.4% ~ 57.8%, the average effective time of 3,8 months to 7.5 months, the effective rate of soft tissue lesions was 28.6% to 50%. Twenty-one of 39 patients had died, and the median survival of these 21 patients diagnosed with hormone-refractory prostate cancer was 16 months. Conclusions The vast majority of patients with hormone-refractory prostate cancer can be diagnosed and followed up with PSA. However, the changes of PSA in very few patients are very small and need to be followed up with foci and symptoms. Chemotherapy is the main method of treating hormone-refractory prostate cancer and has certain curative effect. This group of patients survival time seems longer than the European and American patients.