| Objective:To observe the clinical efficacy of prostate cancer intermittent hormonal therapy in different clinical stages and different pathological grade, analyze the influencing factors which impact the tolerability of therapy.Methods:The patient outcomes were evaluated for32patients who had undergone intermittent hormonal therapy from June2006to March2013. All the patients received maximal androgen blockade treatment, and maintain the treatment for3to6months until PSA below0.2ng/mL. Then review the results of PSA and testosterone monthly, decide whether to begin the next cycle therapy based on the results. To follow up the number of cycles of the patients, the length of treatment period and interim period; observe the adverse reactions of treatment and progression of disease, and score the quality of life. All the patients were divided into two groups according to the clinical efficacy of treatment as well-tolerated and poor-tolerated group. Analysis the differences between the two groups in age, PSA, Gleason score, tumor stage, the number of treatment cycles, whether recurrence, the symptom of dysuria or hematuria, whether lymph node metastasis or bone metastases, etc. Screened statistically significant factors into the logistic regression analysis and explore the influencing factors which impact of the tolerability of therapy.Results:This group of patients has an average age of79.2±7.8years old and average follow-up time of40.8±21.9months. All patients completed the first treatment period,31patients entered the second cycle of treatment,17patients entered the third cycle of treatment, and6patients entered the fourth cycle of treatment, one patient entered the fifth cycle of treatment. The minimum PSA values from the first cycle0.002ng/mL rose to last cycle0.24ng/mL.11cases of all patients appeared disease progression, including3cases with bone metastases.1case in third cycle,3cases in fourth cycle developed androgen independent prostate cancer and2patients died of prostate cancer. During the treatment period, the incidence of hectic fever was31.6%, the incidence of physical decline was59.3%, incidence of osteoporosis was9.4%, and incidence of breast tenderness was18.8%. All the symptoms above were significantly weakened in the interim period. Intellectuals, with good economic capacity and relatively complete med-care patients have higher compliance. Patients with better tolerance had lower PSA values (P=0.046), lower Gleason score (P=0.004), lower tumor stage (P=0.006). Logistic regression analysis showed that tumor stage has distinguished statistically significant in tolerability of therapy (P=0.040), the OR was228.27295,95%CI was1.286to40533.826.Conclusions:The study shows that IHT was suitable for patients with different clinical stages and pathological grades. It can reduce the amount of drugs, cut down treatment costs and improve patients’ quality of life. Most of all, it may extend the time of the androgen-dependent. IHT is safe, effective and feasible. Strengthen the mission for the treatment of disease, improve the health care system may have great significance to improve patient compliance. IHT may be more suitable for patients within the Phase III. |
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