Clinical Analysis Of Two Kinds Of Hormonal Therapy In The Treatment Of Localized Prostate Cancer(T_1-2N₀M₀)

Objective:To compare the efficacy and adverse reactions of intermittent versus continuous hormonal therapy in the treatment of localized prostate cancer.Methods:There are 132 cases of patients with localized prostate cancer(T1-2N0M0)that received hormonal therapy in our hospital in July 2002 to January 2015.of them,60 cases of patients received intermittent hormonal therapy(IHT)and 72 cases of patients received continuous hormonal therapy(CHT).The study analysis the cycle of intermittent hormonal therapy and compare the survival rate,tumor progression rate,incidence of adverse reactions and quality of life in intermittent versus continuous hormonal therapy.Results:1.The follow-up time ranges from 18 to 108 months,mean(56±19.1)months.The survival rate of 1 year,3 years,5 years,8 years was 100%、96.36%、88.24%、69.34% in group of intermittent hormonal therapy.The survival rate of 1 year,3 years,5 years,8 years was 100%、92.19%、71.67%、49.12% in group of continuous hormonal therapy.There were no significant difference between group IHT and CHT in the survival rate of 1 year and 3 years.but there were difference between group IHT and CHT in the survival rate of 5 years and 8 years.2.There were 43.64% patients evolved to androgen independent prostate cancer after 3 years of treatment by IHT,but it was 62.50% in group of CHT,there were significant difference between the two groups.There were 62.27% patients evolved to androgen independent prostate cancer after 5 years of treatment by IHT,but it was 85% in group of CHT,there were significant difference between the two groups.3.The completed ratio in 1 ~ 5 cycles were 100%、88.33%、63.33%、46.67%、 25.00% in group of IHT.The mean time of cycle is(12.01±1.19)months,the average time of treatment was(5.09±1.11)months,the average interval was(6.06±1.25)months.the average interval account for 50.46% of the time of cycle.With the repeating of the cycles,the disease progression rate increased,the interval decreased.4.Compared with before treatment,there were significant difference in the bowel symptoms,urinary symptoms and sexual function after treatment of a year.There were significant difference between the two groups in the bowel symptoms,urinary symptoms and sexual function after treatment of a year.The IHT group had better quality of life.After treatment of 3 years,there were significant difference between the two groups in the rate of Hot flash,Gynecomastia,Anemia and elevated ALT.There were significant difference between the two groups in Osteoporosis,Fracture Weak,and Cognitive impairment.There was significant difference between the two groups in the rate of Cardiovascular accident.Conclusions:Compared with CHT,IHT is safe,feasible and economic on the treatment of localized prostate cancer that can ’t be treated with radical surgery or radiation therapy.Compared with CHT,IHT can improve the survival rates of patients with localized prostate cancer,it can also delay the localized prostate evolved to androgen independent prostate cancer,reduce treatment time.The patients of localized prostate cancer who received the treatment of IHT can get higher quality of life of and fewer side effects.