Yoshimura Koji, Sumiyoshi Yoshiteru, Hashimura Takayuki, Ueda Tomohiro, Kamiryo Yoriaki, Yamamoto Akihiro, Arai Yoichi
Department of Urology, Kurashiki Central Hospital, Kurashiki, Japan.
Int J Urol. 2003 Apr;10(4):190-5. doi: 10.1046/j.0919-8172.2003.00601.x.
We compared the clinical effects and impact on quality of life (QOL) of patients who received a 3-month course of flutamide monotherapy before radical prostatectomy with those who received a 3-month course of luteinizing hormone-releasing hormone (LHRH) agonist monotherapy.
Thirty-seven patients with non-metastatic prostate cancer were enrolled in this study (19, flutamide; 18, LHRH agonist). The rates of change of serum prostate-specific antigen (PSA) and testosterone levels, downsizing of prostate volume, the rate of organ confined disease, adverse effects and perioperative scores measured using the European Organization for Research and Treatment of Cancer Prostate Cancer Quality of Life Questionnaire (EORTC-P) and the Sapporo Medical University Sexual Function Questionnaire (SMUF) were analyzed.
At radical prostatectomy, pathological variables were not significantly different in the two groups. Serum testosterone level was significantly higher (mean 359.2 compared to 10.5, P < 0.001), complete response rate of PSA (13% compared to 57%, P = 0.028) and rate of downsizing of prostate volume (mean, -17.7% compared to -35.4%, P = 0.038) were significantly lower in the flutamide group than in the LHRH group. After neoadjuvant hormone therapy, the scores on the sexual problem domain of EORTC-P (P = 0.033) and sexual desire score of SMUF (P = 0.021) were significantly higher in the flutamide group than in the LHRH group. At a median follow-up of 34 months after prostatectomy, biochemical failure-free survival rate in the flutamide group did not differ from that in the LHRH group.
This study suggests that flutamide monotherapy can be an acceptable modality as an option for neoadjuvant hormone therapy.
我们比较了在根治性前列腺切除术前行3个月氟他胺单药治疗的患者与行3个月促黄体生成素释放激素（LHRH）激动剂单药治疗的患者的临床疗效及对生活质量（QOL）的影响。
37例非转移性前列腺癌患者纳入本研究（19例接受氟他胺治疗；18例接受LHRH激动剂治疗）。分析血清前列腺特异性抗原（PSA）和睾酮水平的变化率、前列腺体积缩小情况、器官局限性疾病发生率、不良反应以及使用欧洲癌症研究与治疗组织前列腺癌生活质量问卷（EORTC-P）和札幌医科大学性功能问卷（SMUF）测量的围手术期评分。
在根治性前列腺切除术中，两组的病理变量无显著差异。氟他胺组的血清睾酮水平显著更高（平均359.2对比10.5，P < 0.001），PSA的完全缓解率（13%对比57%，P = 0.028）和前列腺体积缩小率（平均，-17.7%对比-35.4%，P = 0.038）显著低于LHRH组。新辅助激素治疗后，氟他胺组EORTC-P的性问题领域评分（P = 0.033）和SMUF的性欲评分（P = 0.021）显著高于LHRH组。前列腺切除术后中位随访34个月时，氟他胺组的无生化复发生存率与LHRH组无差异。
本研究表明氟他胺单药治疗可作为新辅助激素治疗的一种可接受的方式。
