The Clinicalanalysis On Intermittent Endocrine Therapy Of Late Prostate Carcinoma

Objective：To evaluate the effect of intermittent androgen suppression（IAS） forthe patients of advanced prostate cancer，and compare the difference of continuousandrogen suppression（CAS）.Methods： Patients who were diagnosed with advanced prostate cancer andreceived intermittent endocrine therapy and had complete follow-up data in thedepartment of urology of the first affiliated hospital of Dalian medical university fromJanuary1，2006to January1，2010were incorporated the experiment.All patients weretreated with operation or medical castration+bicalutamide. Patients were divided intoIAS group and CAS group by intermittent androgen suppression through Goserelinsubcutaneous injection intermittently or continuous androgen suppression throughorchiectomy or Goserelin subcutaneous injection continuously. All patients were followed upfor the law，regular testing PSA levels and other tests，and collect the follow-updata.Using SPSS19.0statistical software analyzed the baseline data，PSA，clinicalcharacteristics，overall survival rate， side effects，treatment costs and progressionto androgen independent prostate cancer time between two groups.Results：（1）183cases who met the inclusion criteria and had complete data werecollected， both by prostate biopsy confirmed locally advanced prostate cancer （T3/T4/NX-1M0） or metastatic prostate cancer（Any TAny N Ml）. Excluding24cases who were missing，24cases without operation only oral drug，12cases withoutoral drug only subcutaneous injection. IAS group had106cases，74patients（69.8%）received medical castration，32patients（30.2%） received operation castration.CASgroup had17case and received operation castration.（2）Comparison of PSA betweenthe IAS group and CAS group，there has no significant difference after3months and6months of treatment（P=0.121and0.948）.（3）Comparison of the rate of urinaryobstruction，bone pain，bone metastasis-positive between the IAS group and CASgroup，urinary obstruction，bone pain，bone metastasis-positive，there has no significantdifference after3months and6months of treatment（P＞0.05）.（4）Comparison of thetotal survival rate between the IAS group and CAS group，there has no significantdifference after3months and6months of treatment（P＞0.05）.（5）Comparison ofprogression to androgen independent prostate cancer time between the IAS group andCAS group，there had significant difference（P=0.044）（.6）Comparison of side effectsbetween the IAS group and CAS group， except for gastrointestinal reactionrate had no significant difference （P=0.081）， intermittent hot flashes， lossof libido and erectile function，osteoporosis and breast distending pain occurredhad significant difference（P=0.024，0.030，0.003，0.032，rspectively）.（7）Comparisonof the costs between the IAS group and CAS group，the average cost of IAS group was（29946±4526）yuan，the average cost of CAS group was（84177±5247）yuan，there had significant difference（P=0.000）.Conclusion： intermittent androgen suppression is an effective method for thetreatment of prostate cancer， which can can significantly delay the progression toandrogen independence prostate cancer time, improve the urinary tract obstruction,painful bone metastases and other symptoms, prolong the survival time, reduce theincidence of side effects during treatment, reducing treatment costs, improve the qualityof life of patients..