多西他赛序贯恩杂鲁胺治疗难治性老年前列腺导管腺癌一例并文献复习

摘要

目的 总结老年前列腺导管腺癌的临床特点,并探索其治疗策略. 方法 报道我院收治的1例老年前列腺导管腺癌患者先后进行了包括内分泌治疗、化疗、放疗及抗雄治疗等综合治疗,总结其临床特点,并进行文献复习. 结果 我院1例老年前列腺导管腺癌患者于2013年11月穿刺诊断后分别接受内分泌治疗、化疗、放疗及恩杂鲁胺单药治疗,该患者对多西他赛敏感性较低,在接受规律恩杂鲁胺单药治疗后,前列腺特异性抗原(PSA)较基线降低超过30倍,双肺结节及纵隔淋巴结较前缩小,骨扫描示骨转移灶较前无明显变化,病情得到缓解.目前,尚无前列腺导管腺癌应用恩杂鲁胺治疗的相关报道. 结论 恩杂鲁胺治疗老年前列腺导管腺癌有效且安全,值得临床应用及推广,今后仍需更多样本的研究以及长期追踪观察.%Objective To summarize the clinical features of prostatic ductal adenocarcinoma and to explore its therapeutic approaches.Methods A case report on an elderly patient with prostatic ductal adenocarcinoma who received endocrine therapy,chemotherapy,radiotherapy,and Enzalutamide therapy after prostate biopsy in November 2013.We summarized and analyzed the patient's clinical manifestations and reviewed relevant literature.Results The patient showed a low sensitivity to Docetaxel;the PSA level of the patient was over 30 times lower than the baseline level after monotherapy with Enzalutamide;bilateral pulmonary nodules and mediastinal lymph nodes reduced in size;a bone scan showed no significant change in bone metastases.At present,there is no report on treatment for prostatic ductal adenocarcinoma with Enzalutamide.Conclusions Enzalutamide therapy is effective and safe for prostate ductal adenocarcinoma and should be encouraged in clinical practice.Studies with larger sample sizes and longer follow-ups are needed in the future.