Clinical Study Of The Efifcacy And Safety Between Triptorelin(Diphereline) Combined With Flutamide And Surgical Castration In Advanced Prostate Cancer

Objective To evaluate the clinical efficacy and side effect ofTriptorelin (Diphereline) combined with Futamide and castration inadvanced prostate cancer.Methods50patients were divided into two groups. Group Aincluded24patients (triptorelin plus flutamide treatment group),Group B included26patients(operation gonadectomy plus flutamidetreatment group).Patients in Group A were treated with flutamidetablets250mg,3times/d immediately after diagnosed. Each of them weregiven an intramuscular injection of15mg triptorelin after oneweek.They were injected every three months for a total of four timeswith a long-term oral flutamide tablets. Patients in Group B takeorchiectomy by Local anesthesia or epidural anesthesia and they weretreated with a long-term oral administration of flutamide tablets.During the endocrine therapy, two groups of patients do not use other endocrine drugs and anticancer drugs. All prostate cancer patientsreturn to hospital for the reexamination3,6,9, and12months afterendocrine therapy. The reexamination includes digital rectalexamination, transrectal color Doppler ultrasound examination, serumPSA determination, isotope bone scan, chest radiograph, micturitionand the state of pain relief. Adverse reactions were recorded duringthe treatment, including changes in liver function, sexual dysfunction,and facial flushing. Two groups of patients were followed up, follow-uptime was12months.Results50patients received the12-months following-up. All theserum PSA were significantly reduced after3,6,9,12months. Thedifference before and after treatment has statistical significance (P<0.01). The clinical efficacy and side effect between Group A and GroupB has no statistical significance.The pain gradually eased in10patients, another one patient with bone pain persisted.19patients in22with obstructive symptoms eased gradually after3months treatment.One patient with neurogenic bladder was given the bladder gastrostomy.Obstructive symptoms relieved not obviously in two patients, and theywere treated with palliative transurethral resection.3patients ingroup A patients have facial flushing during the treatment.1patientsin group B has the mild transaminase elevation. Four cases of adversereactions of patients continue to receive endocrine therapy after the symptomatic treatment.Conclusions(1) Triptorelin or surgical castration combined with flutamidehas good curative effect for advanced prostate cancer.(2) Injection dual hydroxyl naphthoic acid triptorelin andflutamide has less adverse reaction, good patient tolerance foradvanced prostate cancer.