多西紫杉醇联合雌二醇治疗雄激素非依赖性前列腺癌的疗效观察

摘要

Objectives:To investigate the clinical effects and adverse effects of docetaxel combined estradi-ol phosphate nitrogen mustard for androgen independence in prostate cancer.Methods:38 patients with androgen independence in prostate cancer received combined use of docetaxel and estradiol phosphate nitrogen mustard chem-otherapy for 3 course of treatment (28 days,a course).The clinical indicators,such as micturition symptoms,pain response,serum PSA,prostate volume,MFR,and the adverse reaction after chemotherapy before and after treat-ment after 3 course of chemotherapy were compared.Results:The micturition symptoms improved significantly after n treatment in 25 patients;3 cases of micturition waiting,4 cases of the number of night micturition and 6 cases of dripping wet had not improved obviously.The pain reaction significantly improved after the treatment in 32 patients, with distinctly improved micturition symptoms and pain reaction than before treatment (P<0. 05 ).The postopera-tive clinical indicators of serum PSA,prostate volume and MFR significantly improved than before treatment (P<0. 05 ),38 patients had adverse reactions such as nausea,vomiting and the neutropenia after 3 course of chemother-apy.20 patients with filgrastim need to increase granulocyte.Other reverse reactions were in the tolerance range, such as thrombocytopenia,the damage of heart,liver and kidney.Conclusion:The clinical effect of docetaxel com-bined estradiol phosphate nitrogen mustard for androgen independence in prostate cancer is remarkable with slightly adverse reaction,thusly worthy of clinical application.%目的：探讨多西紫杉醇联合磷酸雌二醇氮芥对雄激素非依赖性前列腺癌的临床效果及不良反应。方法：38例晚期雄激素非依赖性前列腺癌患者，全部经去势手术后，联用多西紫杉醇与磷酸雌二醇氮芥进行综合化疗，以28d为1个疗程，经3个疗程治疗后，比较治疗前后患者的排尿症状、疼痛反应、血清PSA、前列腺体积、MFR等临床指标，以及化疗后出现的毒副反应。结果：治疗后25例患者排尿症状明显好转，3例尿等待、4例夜尿次数以及6例尿末淋漓不尽感未明显好转，32例患者疼痛反应明显好转，治疗后排尿症状及疼痛反应均明显好于治疗前（P＜0．05）。患者术后血清PSA、前列腺体积以及MFR等临床指标明显好于治疗前（P＜0．05）。38例患者经化疗3疗程后出现最常见的毒副反应如恶心、呕吐和中性粒细胞减少等，其中20例患者需用重组人粒细胞集落刺激因子升高粒细胞，其余毒副反应如血小板减少、心肝肾等脏器损害均在能耐受范围。结论：多西紫杉醇联合磷酸雌二醇氮芥治疗雄激素非依赖性前列腺癌临床效果显著，毒副反应轻，值得临床推广应用。