Discussion About Therapy For Different Clinical Stages Of Prostate Cancer

Objective: To compare the therapies for different stages of prostate cancer between our hospital and European area in the past 4 years.Method: 91 cases of patients who had been diagnosed of prostate cancer in our hospital.Compared our therapies for these cases with the Guidlines on Prostate Cancer in 2007 published by EAU.Result: In clinical T1~T2c group,66.7%(4/6) had RP, and 33.3%(2/6) got ADT.In T3~T4,92.3%(12/13) had ADT, and the percent of ADT match RT is 7.7%(1/13). In N+ M0, 91.1%(41/45) got ADT,and 6.7%(3/45) had ADT match RT,2.2%(1/53) had interstitial brachytherapy. The serum PSA level decreased obviously after a four-year follow-up.Discuss: Patients with clinical stage T1 are in the earlier period of prostate cancer.EAU suggests thatsurveillance is a reasonable and often preferable option for a wider range of patients, for example ,for those with a life expectancy of less than 10 years .Others is recommended to get ADT.In our country,most patients had strided over this stage when they came to hospital. The reasons were various. The key step of containment of prostate cancer is PSA census.For T1b~T2c patients,RP or NHT match RP is the suggestion.The reason as follows:First, clinical disease-free survival of these patients who had RP is acceptable.Second, For RP patients, ADT has been studied in the setting of high-risk disease. Adjuvant hormonal therapy has shown to improve progression-free survival and disease specific survival, particularly for patients without depositive disease.4 in 6 patients who received therapy in our hospital were fit for RP, and others were given ADT because of their ages.But the suggestion of EAU is that surveillance is preferable for patients without symptoms.However,patients with stage T3~T4 have less choices.Giving RT or RT match ADT(NHT) is EAU's recommendation.At last, simple ADT is reasonable for those before dying .During the past 4 years ,we had recommended patients to get ADT(Goserelin+Becalutamide),and average PSA level had decreased 90.2%. Many patients were not candidates for adjuvantor salvage therapy, or even definitive local treatment. Others still progressed despite given aggressive local and salvage therapy. At last, for those recurence after RP, ADT remains the choice of treatment for the vast majority of these patients, and LHRH agonists have replaced orchiectomy as a standard therapy.Conclusion: RP or NHT match RP is suitable for T1b~T2c.RT match ADT(NHT) is the suggestion for T3~T4,but the side effects must be considered. ADT is reasonable for advanced stage to improve the quality of life. The measurement of PSA level is a cornerstone of follow-up after curative treatment.