内分泌治疗联合唑来膦酸对前列腺癌骨转移的的疗效观察.docVIP

内分泌治疗联合唑来膦酸对前列腺癌骨转移的的疗效观察 　　【摘要】 目的：探讨内分泌治疗联合唑来膦酸对前列腺癌骨转移及骨痛的疗效。方法：选取2010年1月-2015年6月在笔者所在医院住院的前列腺癌骨转移患者50例，所选患者均采用唑来膦酸联合内分泌治疗，观察治疗后效果。结果：治疗后止痛总有效率为92%。治疗前，血清PSA为20～100 ng/ml的患者12例，血清PSA≥100 ng/ml的患者38例；治疗后，38例患者的PSA≤4 ng/ml，2例患者的PSA在4～10 ng/ml之间，7例患者的PSA在10～50 ng/ml之间，仅3例患者的PSA≥50 ng/ml。不良反应为潮热、乳房胀痛、轻度的发热、血小板降低、胃肠道不适，经对症处理后逐渐缓解。结论：内分泌治疗联合唑来膦酸对前列腺癌骨转移及骨痛的治疗是有效的、安全的。 　　【关键词】 前列腺癌骨转移； 内分泌治疗； 唑来膦酸 　　中图分类号 R737.25 文献标识码 A 文章编号 1674-6805（2016）15-0012-03 　　【Abstract】 Objective：To explore the efficacy of hormone treatment combined with Zoledronic Acid for the ostalgia and bone metastasis of prostatic cancer.Method：Fifty patients who were diagnosed with bone metastasis of prostatic cancer in our hospital from January 2010 to June 2015 received Zoledronic Acid and hormone treatment.The treatment effect was observed.Result：After treatment，the total effective rate of analgesia was 92%.Before treatment，the serum PSA of 12 patients were 20-100 ng/ml，38 patients were ≥100 ng/ml.After treatment，the serum PSA of 38 patients was ≤4 ng/ml，2 patients were 4-10 ng/ml，7 patients were 10-50 ng/ml，only 3 patients were ≥50 ng/ml.Adverse reactions were hot flashes，breast tenderness，mild fever，thrombocytopenia and gastrointestinal discomfort，after symptomatic treatment the adverse reactions above gradually eased.Conclusion：Hormone treatment combined with Zoledronic Acid is effective and safe in the treatment of bone metastasis of prostatic cancer. 　　【Key words】 Prostate cancer with bone metastasis； Hormone treatment； Zoledronic Acid 　　First-author’s address：North District of Suzhou Municipal Hospital Affiliated to Nanjing Medical University，Suzhou 215008，China 　　doi：10.14033/j.cnki.cfmr.2016.15.005 　　前列腺癌（PCa）是一种见于老年男性泌尿系统的恶性肿瘤。近年来的研究发现，前列腺癌在我国的发病率呈上升趋势。PCa发病后骨转移发生率高，国外相关报道骨转移的发生率为50%～80%[1]。PCa是唯一最先发生骨转移而非内脏转移的实体肿瘤，骨转移是PCa主要致死原因[2]。骨转移相关疼痛严重影响患者的生理、心理健康，降低其生活质量。唑来膦酸（zoledronic acid）为新一代的双膦酸盐类药物，是破骨细胞前体的高强度骨吸收抑制剂，针对恶性肿瘤骨转移镇痛效果好。绝大部分前列腺癌是雄激素依赖性的，故内分泌治疗成为晚期前列腺癌的首选治疗方法。本文对50例采用内分泌治疗联合唑来