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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(χ2=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(χ2=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(χ2=5.168,P=0.023);8年生存率差异有统计学意义(χ2=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。
Objective: To investigate the clinical value of intermittent endocrine therapy combined with intensity-modulated conformal radiation therapy in the treatment of localized prostate cancer. Methods: Seventy-two patients with localized prostate cancer were selected and divided into two groups: 37 patients in combination group and intermittent endocrine therapy combined with intensity-modulated conformal radiation therapy. 35 patients in simple therapy group were treated with simple intensity-modulated conformal radiotherapy. The clinical symptom remission rate, the change of prostate volume, the change of serum PSA, the tumor control rate, the incidence of adverse reactions and the survival rate were compared between the two groups. Results: The follow-up ranged from 5 to 118 months, an average of 56 months. The difference of clinical symptom relief rate between the combined treatment group and the simple treatment group was statistically significant (χ2 = 3.280, P = 0.036); the difference of the prostate volume difference was statistically significant (t = 5.1353, P = 0.000) <0.2μg / L, the difference was statistically significant (χ2 = 20.182, P = 0.000); 1, 3, 5 and 8 years PSA progression-free survival rates were statistically significant (P <0.05 ). No deaths occurred in 1 year and 3 years, and the difference was not statistically significant. The 5-year survival rate was significantly different (χ2 = 5.168, P = 0.023). The difference of 8-year survival rate was statistically significant (χ2 = 5.061, P = 0.024). There was a significant difference in the incidence of adverse reactions in early radiotherapy (P <0.05). Conclusion: Intermittent endocrine therapy combined with intensity-modulated conformal radiation therapy can significantly improve the clinical symptoms of patients with prostate cancer, reduce serum PSA levels, improve disease control and patient survival rates, reduce the incidence of adverse reactions in early radiotherapy, the effect is better than pure Intensified conformal radiotherapy is a safe and effective treatment.