外放射治疗联合内分泌治疗对前列腺癌根治术后生化复发患者的影响

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摘要目的评价前列腺癌根治术后出现生化复发患者行放射治疗联合内分泌治疗的效果。方法选取2010年1月至2018年12月在江苏省徐州市中心医院泌尿外科接受前列腺癌根治术后出现生化复发并接受治疗的132例患者，依据生化复发后采用治疗方案的不同，将其分为外放射治疗组（36例）、内分泌治疗组（45例）和联合治疗组（外放射治疗联合内分泌治疗，51例）。收集并比较三组临床资料，随访后比较三组生存期及不良反应发生情况。结果三组年龄、体重指数、术前前列腺特异性抗原（PSA）、Gleason评分、临床分期、PSA倍增时间比较，差异无统计学意义（P ＞ 0.05）。所有患者随访24～132个月，中位随访时间为63.5个月。外放射治疗组、内分泌治疗组和联合治疗组的无生化复发生存率为50.0%、51.1%和66.7%，中位生存期分别为62.0、67.9、78.1个月，联合治疗组的无生化复发生存率高于外放射治疗组和内分泌治疗组，差异有统计学意义（P ＜ 0.05）。三组潮热、尿道反应、肠道反应及性功能障碍发生率比较，差异无统计学意义（P ＞ 0.05）。结论对于前列腺癌根治术后出现生化复发的患者，外放射治疗联合内分泌治疗组在延长中位生存期方面更具优势，不良反应无明显差别，更能获得生存获益与治疗安全性之间的平衡。

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	魏振宁1
	2 王希涛2 史振铎2 郝林2 周家合2 夏天3 杜骏飞3 韩从辉1
	2▲

关键词 ：前列腺癌, 生化复发, 外放射治疗, 内分泌治疗

Abstract：Objective To evaluate the effects of external radiotherapy combined with endocrine therapy on patients with biochemical recurrence after radical prostatectomy. Methods A total of 132 patients with biochemical recurrence after radical prostatic cancer surgery in Department of Urology, Xuzhou Central Hospital of Jiangsu Province from January 2010 to December 2018 were selected. According to the different treatment regimens after biochemical recurrence, the patients were divided into three groups: external radiotherapy group (36 cases), endocrine therapy group (45 cases), and combined treatment group (external radiotherapy combined with endocrine therapy, 51 cases). The clinical data of the three groups were collected and compared, and the survival and adverse reactions of the three groups were compared after follow-up. Results There were no significant differences in age, body mass index, preoperative prostate specific antigen (PSA), Gleason score, clinical stage, and PSA doubling time among the three groups (P ＞ 0.05). All patients were followed up for 24 to 132 months, with a median follow-up of 63.5 months. Biochemical recurence-free survival rates were 50.0%, 51.1% and 66.7% in the external radiotherapy group, the endocrine therapy group, and the combination treatment group, with median survival rates of 62.0, 67.9, and 78.1 months, respectively. The biochemical recurence-free survival rates in the combination treatment group were higher than those in the external radiotherapy group and the endocrine therapy group, the difference was statistically significant (P ＜ 0.05). There were no significant differences in the incidence of hot flashes, urethral reactions, intestinal reactions, and sexual dysfunction among the three groups (P ＞ 0.05). Conclusion For patients with biochemical recurrence after radical prostatectomy, the combination of external radiotherapy and endocrine therapy group had more advantages in prolonging median survival time, and there was no significant difference in adverse reactions. Overall, the balance between survival benefit and treatment safety was better achieved.

Key words： Prostate cancer Biochemical recurrence Endocrine therapy Radiotherapy

基金资助:国家重点研发计划项目（2017YFC0908000）；
江苏省医学创新团队项目（CXTD-2017-48）；
江苏省徐州市卫生创新（技术攻关）团队项目（XWCX201603）；
江苏省徐州市引进临床专家团队项目项目（2018TD004）。

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引用本文:

魏振宁1,2 王希涛2 史振铎2 郝林2 周家合2 夏天3 杜骏飞3 韩从辉1,2▲. 外放射治疗联合内分泌治疗对前列腺癌根治术后生化复发患者的影响[J]. 中国医药导报, 2022, 19(11): 103-106.
WEI Zhenning1,2 WANG Xitao2 SHI Zhenduo2 HAO Lin2 ZHOU Jiahe2 XIA Tian3 DU Junfei3 HAN Conghui1,2▲. Effects of external radiotherapy combined with endocrine therapy on patients with biochemical recurrence after radical prostatectomy#br#. 中国医药导报, 2022, 19(11): 103-106.

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[1] Siegel RL，Miller KD，Jemal A. Cancer statistics，2019 [J]. CA Cancer J Clin，2019，69（1）：7-34.
[2] van der Poel HG，van den Bergh RCN，Briers E，et al. Focal Therapy in Primary Localised Prostate Cancer：The European Association of Urology Position in 2018 [J]. Eur Urol，2018，74（1）：84-91.
[3] Kanehira M，Takata R，Ishii S，et al. Predictive factors for short-term biochemical recurrence-free survival after robot-assisted laparoscopic radical prostatectomy in high-risk prostate cancer patients [J]. Int J Clin Oncol，2019，24（9）：1099-1104.
[4] Punnen S，Cooperberg MR，D’Amico AV，et al. Management of Biochemical Recurrence After Primary Treatment of Prostate Cancer：A Systematic Review of the Literature [J]. European Urology，2013，64（6）：905-915.
[5] May EJ，Viers LD，Viers BR，et al. Prostate cancer post-treatment follow-up and recurrence evaluation [J]. Abdom Radiol （NY），2016，41（5）：862-876.
[6] Rosenbaum E，Partin A，Eisenberger MA. Biochemical relapse after primary treatment for prostate cancer：Studies on natural history and therapeutic considerations [J]. J Natl Compr Canc Netw，2004，2（3）：249-256.
[7] Cookson MS，Aus G，Burnett AL，et al. Variation in the definition of biochemical recurrence in patients treated for localized prostate cancer：the American Urological Association Prostate Guidelines for Localized Prostate Cancer Update Panel report and recommendations for a standard in the reporting of surgical outcomes [J]. J Urol，2007，177（2）：540-545.
[8] 陈彦君，刘建萍，龚志勇，等.预测前列腺癌根治术后生化复发的研究[J].医学信息，2021，34（5）：49-53.
[9] Hashimoto T，Nakashima J，Kashima T，et al. Predicting factors for progression to castration resistance prostate cancer after biochemical recurrence in patients with clinically localized prostate cancer who underwent radical prostatectomy [J]. Int J Clin Oncol,2020，25（9）：1704-1710.
[10] 白培德，姜昊文.肥胖与根治性前列腺切除术后前列腺癌生化复发的关系[J].复旦学报，2014，41（4）：565-568.
[11] 侯佩先，金坤，邱实.中性粒细胞和淋巴细胞比值对根治性前列腺切除术患者生化复发的影响[J].现代泌尿外科杂志，2020，25（5）：392-396.
[12] 王一宁，陈若华，陈虞梅，等.68Ga-PSMA-11 PET/CT与18F-FDG PET/CT诊断前列腺癌生化复发的对比研究[J].中华核医学与分子影像杂志，2020，40（8）：470-474.
[13] 徐礼臻，朱再生，徐旻.前列腺癌组织中驱动蛋白5的表达及其与5年进展和生化复发的关系[J].浙江医学，2020，42（24）：5.
[14] 孙文国，夏利，蒋雷鸣，等.术前不同PHI水平对前列腺癌诊断及生化复发的影响分析[J].安徽医科大学学报，2020，56（5）：815-818.
[15] 岑昕贝，凌济忠，万跃平，等.NR3C1表达与前列腺癌生化复发的相关性研究[J].广州医药，2020，51（4）：22-27.
[16] 韩兆冬，罗宏伟，林卓远，等.PRC1高表达与前列腺癌生化复发的相关性研究[J].新医学，2016，47（7）：442-446.
[17] Shipley WU，Seiferheld W，Lukka HR，et al. NRG Oncology RTOG. Radiation with or without Antiandrogen Therapy in Recurrent Prostate Cancer [J]. N Engl J Med，2017，376（5）：417-428.
[18] Beck M，Hayoz S，Ghadjar P，et al. Re：Radiation With or Without Antiandrogen Therapy in Recurrent Prostate Cancer [J]. Eur Urol，2017，72（2）：319.
[19] Spratt DE，Dess RT，Zumsteg ZS，et al. A Systematic Review and Framework for the Use of Hormone Therapy with Salvage Radiation Therapy for Recurrent Prostate Cancer [J]. Eur Urol，2018，73（2）：156-165.
[20] Spratt DE. Evidence-based Risk Stratification to Guide Hormone Therapy Use With Salvage Radiation Therapy for Prostate Cancer [J]. Int J Radiat Oncol Biol Phys，2018，102（3）：556-560.
[21] Nagaya N，Nagata M，Lu Y，et al. Prostate-specific membrane antigen in circulating tumor cells is a new poor prognostic marker for castration-resistant prostate cancer [J]. PLoS One，2020，15（1）：e0226219.
[22] Horning AM，Wang Y，Lin CK，et al. Single-Cell RNA-seq Reveals a Subpopulation of Prostate Cancer Cells with Enhanced Cell-Cycle-Related Transcription and Attenuated Androgen Response [J]. Cancer Res，2018，78（4）：853-864.
[23] Supiot S，Campion L，Pommier P，et al. Combined abiraterone，salvage prostate bed radiotherapy and LH-RH agonists（CARLHA）in biochemically-relapsing prostate cancer patients following prostatectomy：a phase Ⅰ study of the GETUG/GEP [J]. J Clin Oncol，2018，9（31）：22147-22157.
[24] Carrie C，Hasbini A，de Laroche G，et al. Salvage radiotherapy with or without short-term hormone therapy for rising prostate-specific antigen concentration after radical prostatectomy（GETUG-AFU 16）：a randomised，multicentre，open-label phase 3 trial [J]. Lancet Oncol，2016， 17（6）：747-756.
[25] Mohler JL，Antonarakis ES，Armstrong AJ，et al. Prostate Cancer，Version 2.2019，NCCN Clinical Practice Guidelines in Oncology [J]. J Natl Compr Canc Netw，2019，17（5）：479-505.