目的 探讨包膜内手术去势联合雄激素阻断疗法治疗进展期前列腺癌的效果.方法 选择2012年1月至2015年12月进展期前列腺癌患者48例.分为对照组、观察组和试验组各16例.对照组患者应用药物去势疗法治疗,观察组患者应用常规手术去势联合雄激素阻断疗法治疗,试验组患者联合应用包膜内手术去势疗法和雄激素阻断疗法治疗.比较三组患者治疗前后前列腺特异性抗原(PSA)水平、生活质量(QOL)评分、病情稳定期持续时间(即患者癌灶未继续扩大持续时间)、复发和去势抵抗时间、生存时间.结果 试验组和观察组患者PSA水平、QOL评分、病情稳定期持续时间、复发和去势抵抗时间、生存时间均明显优于对照组患者,差异有统计学意义(P<0.05).而试验组和观察组患者差异无统计学意义(P>0.05).结论 联合使用包膜内手术去势和雄激素阻断疗法与常规手术去势和雄激素阻断疗法治疗局部进展期前列腺癌的疗效均较单纯药物去势更确切,可有效降低患者体内PSA水平,延长其复发和去势抵抗的时间,改善其生活质量,延长其生存期,但包膜内手术去势患者因保留睾丸原有的形态,对患者的心理影响较小,且疗效与常规去势效果一致,值得临床推广.
Objective To explore the effect of combined use of surgical castration of capsulotomy and androgen blocking therapy in the treatment of advanced prostate cancer. Methods 48 patients with advanced prostate cancer who were admitted to our hospital from January 2012 to December 2015 were selected as the study subjects.The 48 patients were divided into control group,observation group and experimental group,16 cases in each group. In the control group,the patients were treated with the drug emasculation therapy,the patients in the observation group were treated with conventional surgical castration and androgen blocking therapy. The patients in the experimental group were treated with surgical castration of capsulotomy and androgen blocking therapy. The prostate specific antigen(PSA)level,quality of life(QOL)score,the duration of the illness stability(i.e., the duration of the patients with cancer not to continue to expand),the time of relapsing and castration resistance and and survival time in the three groups of patients before and after treatment were compared. Results The level of PSA in the observation group and experimental group,the score of QOL,the duration of stable condition,the time of relapsing and castration resistance and survival time were significantly better than those in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference between the experimental group and the observation group(P>0.05). Conclusion Combined use of surgical castration of capsulotomy and androgen blocking therapy or conventional surgical castration and androgen blocking therapy in the treatment of locally advanced prostate cancer curative effect are more accurate than simple drug castration,can effectively reduce the patients of PSA levels,prolongs the time of relapsing and castration,improve their life quality and prolong the survival period.However,the patients' psychological effect is small due to the retention of the original form of the testicle,and the effect is consistent with the conventional effect,which is worth recommending.