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目的观察去雄激素治疗前列腺癌的不良反应,并探讨其预防和治疗。方法回顾性分析1998年7月-2006年1月112例去雄激素治疗晚期前列腺癌的临床资料。结果112例患者中,97例完成了不良反应的调查。随访3-36月,去雄激素治疗后潮热、性功能障碍、病理性骨折发生率分别为46％、75％、4％;患者潮热、精神疲乏、四肢乏力、纳差症状明显加重(P<0．05);性功能明显减退(P<0．05)。12例潮热症状严重者使用抗抑郁药博乐欣(25mg,tid)1-2周症状减轻。7例有骨转移性疼痛或严重骨质疏松患者,应用唑来膦酸4mg静脉滴注,每45d一次,骨痛症状缓解。结论去雄激素对前列腺癌患者生活质量有一定影响。博乐欣可减轻患者潮热症状,唑来膦酸可预防和治疗去雄激素相关的骨质疏松并发症。
Objective To observe the adverse effects of androgen deprivation on prostate cancer and to explore its prevention and treatment. Methods The clinical data of 112 cases of ex-androgen therapy for advanced prostate cancer from July 1998 to January 2006 were retrospectively analyzed. Results Among 112 patients, 97 patients completed the investigation of adverse reactions. Follow-up 3-36 months, androgen therapy, hot flashes, sexual dysfunction, the incidence of pathological fractures were 46%, 75%, 4%; hot flashes in patients with mental fatigue, limb weakness, anorexia worsened significantly P <0.05); sexual function decreased significantly (P <0.05). 12 cases of severe symptoms of hot flashes with anti-depressants Borax (25mg, tid) 1-2 weeks to reduce symptoms. Seven patients with bone metastatic pain or severe osteoporosis, intravenous infusion of 4mg zoledronic acid, once every 45d, the pain relief. Conclusion Androgen deprivation has a certain impact on the quality of life of patients with prostate cancer. Bleben reduces the symptoms of hot flashes in patients and zoledronic acid prevents and treats the androgen-related complications of osteoporosis.