戈舍瑞林联合比卡鲁胺间歇性与连续性治疗对晚期前列腺癌患者前列腺抗原及免疫功能的影响

摘要

目的:探讨戈舍瑞林联合比卡鲁胺间歇性治疗与连续性治疗对前列腺癌患者前列腺抗原、免疫功能的影响.方法:选择晚期前列腺癌患者63例,随机分为观察组32例和对照组31例.观察组接受戈舍瑞林联合比卡鲁胺间歇性治疗,对照组患者接受戈舍瑞林联合比卡鲁胺连续性治疗.治疗前及治疗后3、6、9、12个月时,比较两组前列腺抗原、血管内皮生长因子、免疫功能、不良反应.结果:治疗后3个月、6个月、9个月、12个月时,两组患者血清前列腺特异性抗原(PSA)、游离前列腺特异抗原(F-PSA)水平均明显低于治疗前(P<0.05),血清血管内皮生长因子(VEGF)水平显著低于治疗前(P<0.05),外周血中CD3+、CD4+、CD4/CD8淋巴细胞的水平明显高于治疗前,CD8+T淋巴细胞亚群的水平明显低于治疗前(P<0.05),两组间PSA、F-PSA、VEGF、CD3+、CD4+、CD4/CD8水平比较差异无统计学意义(P>0.05);两组不良反应发生率比较差异亦无统计学意义(6.25％vs 18.75％)(P>0.05).结论:戈舍瑞林联合比卡鲁胺间歇性治疗的疗效与连续性治疗相当,均能有效降低PSA、VEGF水平并调节免疫功能,但间歇性治疗降低了医疗费用,提高了患者的依从性.%Objective:To investigate the effect of intermittent treatment and continuous treatment with goserelin combined with bicalutamide on prostate antigen and immune function in patients with prostate cancer. Methods:Sixty-three patients with advanced prostate cancer were randomly divided into the observation group (n = 32)and the control group (n = 31). The observation group received intermittent treatment with goserelin combined with bicalu-tamide,and the control group received continuous treatment with goserelin combined with bicalutamide. Before treat-ment and at 3 months,6 months,9 months and 12 months after treatment,the prostate antigen,vascular endothelial growth factor,immune function and adverse reactions were compared between the two groups. Results:At 3 months,6 months,9 months and 12 months after treatment,the levels of serum prostate specific antigen (PSA)and free prostate specific antigen (F-PSA)of the two groups were significantly lower than those before treatment (P < 0. 05). The levels of serum vascular endothelial growth factor (VEGF)were significantly lower than those before treatment (P <0. 05). The levels of CD3 +,CD4 + and CD4 / CD8 lymphocytes in peripheral blood were significantly higher than those before treatment,and the levels of CD8 + T lymphocyte subsets were significantly lower than those before treatment (P< 0. 05). There were no statistically significant differences in the levels of PSA,F-PSA,VEGF,CD3 +,CD4 + and CD4 / CD8 between the two groups (P >0. 05),and there were no statistically significant differences in adverse reactions between the two groups (6. 25% vs 18. 75% )(P > 0. 05). Conclusion:The curative effect of intermittent treatment with goserelin combined with bicalutamide is comparable to that of continuous treatment,and both two kinds of treatment can effectively reduce the levels of PSA and VEGF as well as regulate the immune function. However,intermittent treatment can help to reduce the medical expenses and improve the patient's compliance.