Henriksson P, Stege R
Huddinge University Hospital.
Int J Technol Assess Health Care. 1991;7(2):220-5. doi: 10.1017/s0266462300005110.
The present study compares the cost of antitumor therapy and adverse cardiovascular effects during the first year of treatment with oral estrogens, nonoral estrogens, or surgical castration in patients with prostatic cancer. We found a much higher cost for patients treated with orchidectomy and oral estrogens than for patients treated with nonoral estrogens. Twenty-five percent of the patients treated with oral estrogen suffered cardiovascular complications, compared to none of the patients treated by orchidectomy or nonoral estrogens. The initial cost of orchidectomy as compared to nonoral estrogen treatment was shown not be balanced within the expected survival time of patients with advanced prostatic cancer. Furthermore, surgical castration causes psychological trauma to the patient. We recommend parenteral estrogen therapy as a low-cost therapeutic regimen in patients with prostatic cancer.
本研究比较了口服雌激素、非口服雌激素或手术去势治疗前列腺癌患者第一年的抗肿瘤治疗成本和心血管不良影响。我们发现，接受睾丸切除术和口服雌激素治疗的患者的成本比接受非口服雌激素治疗的患者高得多。接受口服雌激素治疗的患者中有25%出现心血管并发症，而接受睾丸切除术或非口服雌激素治疗的患者均未出现此类情况。与非口服雌激素治疗相比，睾丸切除术的初始成本在晚期前列腺癌患者的预期生存时间内未达到平衡。此外，手术去势会给患者造成心理创伤。我们建议将胃肠外雌激素治疗作为前列腺癌患者的低成本治疗方案。
