全雄激素阻断联合89锶治疗晚期前列腺癌伴骨转移临床疗效.docVIP

全雄激素阻断联合89锶治疗晚期前列腺癌伴骨转移临床疗效 　【摘要】 目的 探讨全雄激素阻断联合放射性核素89锶(89Sr)治疗晚期前列腺癌骨转移的临床疗效和不良反应。方法 通过37例晚期前列腺癌骨转移患者行全雄激素阻断后联合放射性核素89 Sr的治疗，观察骨转移灶变化、止痛效果、血清前列腺特异性抗原(PSA)变化，不良反应。结果 37例患者经治疗后骨显像显示骨转移灶可见异常浓聚灶消退18 例，占48.6%；骨转移灶可见异常浓聚灶变浅10例，占27.1%，总有效为28例，占75.7%；止痛效果：显著有效15例，占40.5%，部分有效18例，占48.6%，总有效33例，占89.1%；37例患者血清前列腺特异性抗原(PSA)均有不同程度下降，其中0～4.00ng/mL8例，占21.6%，4.00～10.00ng/mL 14例，占37.8%；不良反应少。结论 全雄激素阻断联合放射性核素89 Sr治疗晚期前列腺癌骨转移对骨转移灶有消除、抑制生长作用，不良反应少，止痛效果明显，是一种安全有效的方法。 【关键词】 前列腺癌；骨转移；全雄激素阻断；放射性核素89 Sr 　 　　Abstract:　Objective To discuss the clinical efficiency and side effects of androgen deprivation combined with strontium-89 chloride radionuclide therapy for osseous metastases in advanced prostate cancer. Methods 37 cases of advanced prostate cancer with bone metastasis accepted the treatment of androgen deprivation therapy and intravenous infusion of strontium-89 chloride. The changes of bone metastasic focus of the tumor, the effect of pain relief, the serum PSA level and the side effects were observed. Results After therapy,the bone SPECT showed that the bone metastasic focus of 18 cases vanished and accounted for 48.6%(18/37)；10 cases decreased and accounted for 27.1%(10/37). The total improved rate was 75.7%(28/37).The effective rate of bone metastasis pain relief : 15 cases showed remarkable efficiency and accounted for 40.5% (15/37)；18 cases showed partial efficiency and accounted for 48.6%(18/37)；the total improved rate was 89.1%(33/37). The PSA level in 8 cased decreased to 0～4.00ng/mL cases(21.6%)，14 cases to 4.00～10.00ng/mL(37.8%）. No severe side effects during treatment were found. Conclusion The results showed that the androgen deprivation combined with Strontium-89 chloride therapy had a favourable therapeutic value on bone metastases and also had effect in relief of the pain caused by bone metastases in advanced prostate cancer. It is a secure and effective therapeutic method for advanced prostate cancer with bone metastases 　　Key words: prostate cancer；bone metastases；an