【摘要】 目的探讨调强放疗(IMRT)联合新辅助内分泌方法(NHT)治疗局限期前列腺癌的疗效,分析无生化复发生存相关影响因素。方法 54例前列腺癌患者行IMRT前均接受NHT治疗,根据NHT时间不同分为A(NHT3个月)和B组(NHT6个月),各27例。观察2组NHT治疗前、放疗前和放疗后3、6和12个月时血清前列腺特异性抗原(PSA)水平,前列腺体积和最大尿流率(Qmax)变化,并分析患者无生化复发生存影响因素。结果 NHT治疗后2组血清PSA均显著下降(P<0.05或P<0.01),12月时B组下降程度大于A组(P<0.01);NHT联合IMRT后3个月,2组前列腺体积均显著下降(P<0.01),Qmax均显著上升(P<0.01);2组前列腺体积在放疗后各检测点差异无统计学意义(P>0.05),2组Qmax在放疗后6、12个月时比较差异有统计学意义(P<0.05)。单因素分析结果显示,放疗前PSA水平、PSA nadir、危险度分组是无生化复发生存影响因素。结论 IMRT联合NHT治疗局限期前列腺癌疗效显著,IMRT前行NHT能有效控制PSA水平,改善生存质量。更多还原

【Abstract】 Objective To explore the effect of intensity modulated radiation therapy( IMRT) combined with neoadjuvant endocrine therapy( NHT) on treatment of patients with localised prostate cancer and to analyze the related factors of biochemical recurrence-free survival. Methods Fifty-four patients with prostate cancer underwent IMRT before NHT treatment. All patients were divided into group A( NHT 3 months) and group B( NHT 6 months) according to the duration of NHT treatment,27 cases in each group. Serum prostate-specific antigen( PSA) levels,prostate volume,and maximum urinary flow rate( Qmax) of two groups were observed before NHT treatment and radiotherapy and 3,6 and 12 months after radiotherapy. The related factors of biochemical recurrence-free survival were analyzed during follow up. Results After NHT therapy,the PSA levels decreased significantly in all patients( P < 0. 0 5 or P < 0. 0 1),with a better degree in the group B when compared with the group A( P < 0. 0 1) in 1 2 months. Three months after NHT combined with IMRT therapy,the prostate volume of both groups reduced( P < 0. 0 1) and Qmax increased( P < 0. 0 1) obviously. The differences of prostate volume after radiotherapy at each test point were not statistically significant between two groups( P > 0. 0 5),while the differences of Qmax6 and 1 2 months between groups after radiotherapy were significant( P < 0. 0 5). Univariate analysis showed that PSA level,PSA nadir,risk group classification before radiotherapy were influencing factors of biochemical recurrence-free survival. Conclusion Intensity modulated radiation therapy( IMRT) combined with neoadjuvant hormonal method( NHT) therapy has a significant effect in treating patients with localised prostate cancer. NHT treatment before IMRT can effectively control PSA level and improve quality of life.更多还原