雄激素全阻断对前列腺癌患者下尿路症状的改善作用

摘要

目的:探寻雄激素全阻断(maximal androgen blockade,MAB)治疗前列腺癌(prostate cancer,PCa)患者下尿路症状(lower urinary tract symptoms,LUTS)达到最大改善的时间,为其治疗方案的确定提供指导.方法:对并发下尿路症状的45例PCa患者进行雄激素全阻断治疗,分别在雄激素全阻断治疗前、雄激素全阻断3,6,9个月及以后的随访中观察患者国际前列腺症状评分( international prostate symptom score,IPSS)、最大尿流率(Qmax=)的变化,分析两者在雄激素全阻断治疗前、雄激素全阻断3,6,9个月及以后的阶段中是否存在差异,并观察前列腺体积的变化,分析雄激素全阻断对前列腺癌患者下尿路症状的改善作用.结果:45例患者雄激素全阻断前和雄激素全阻断3个月后患者IPSS,Qmax差异有统计学意义(P＜0.05)；雄激素全阻断3个月和6个月相比,IPSS,Qmax差异无统计学意义(P＞0.05).前列腺体积在雄激素全阻断3个月与6个月时比较,差异有统计学意义(P＜0.05)；6个月与9个月时比较,差异无统计学意义(P＞0.05).结论:雄激素全阻断能改善前列腺癌患者的下尿路症状,主要表现在雄激素全阻断治疗后的3个月.%Objective To investigate the timing of reaching maximum improvement of the lower urinary tract symptoms ( LUTS) in patients with advanced prostate cancer treated with maximal androgen blockade ( MAB), and to provide guidelines for the treatment program. Methods We collected the data of 45 advanced prostate cancer patients complicated with lower urinary tract symptoms who were treated by MAB. The international prostate symptom score (IPSS) and maximum urinary flow rate (Qmax) were selected as indicators reflecting the degree of lower urinary tract symptoms and were observed before the MAB, 3,6, and 9 months after the patients received MAB. We also observed the changes of prostate volume and analyzed the role of MAB in improving LUTS in patients with prostate cancer. Results The IPSS and Qmax had significant difference between the 3rd month after the patients received MAB and before the MAB (P < 0. 05 ). No significant difference was found between the 3rd month and the 6th month after the patients received MAB (P >0.05).The prostate volume had significant difference in the 3rd month and the 6th month ( P < 0.05 ) , but no significant difference in the 6th month and the 9th month (P > 0. 05 ). Conclusion MAB for patients with advanced prostate cancer can improve their lower urinary tract symptoms, whose main effect is presented in the 3rd months after the androgen deprivation therapy.