前立腺癌病期B,Cにおける内分泌療法の臨床的検討

Abstract

内分泌療法を施行した前立腺癌病期B:183例と病期C:65例を対象に, 全生存率, 疾患特異生存率, PSA再発率及びその予測因子を検討した.全生存率は病期Bが病期Cより有意に良好で, 5年生存率は病期B:65.6%, 病期C:33.0%であった.疾患特異生存率とPSA非再発率も病期Bが有意に良好で, 5年特異生存率は病期B:95.2%, 病期C:80.8%であった.また5年PSA非再発率は病期B:81.8%, 病期C:44.4%であった.次に病期B, 病期Cの疾患特異生存率とPSA非再発率の予測因子を診断時PSA, Gleason score, 年齢, PSに関して検討した.病期Bの疾患特異生存率に関しては, PSA≦10ng/mlと≧50ng/ml, Gleason score≦6と≧8及びGleason score7と≧8において有意差をもって各々前者が良好であった.PSA非再発率に関してもPSA≦10ng/mlと≧50ng/ml, Gleason score≦6と≧8において前者が有意に良好であった.病期Cに関しては疾患特異生存率, PSA非再発率共に有意差を示す因子はなかった

To evaluate the usefulness of endocrine therapy for stage B and C prostate cancer, we carried out a retrospective study on overall survival rate, cause-specific survival, PSA recurrence-free rate, and their predictive factors in 118 patients with stage B prostate cancer, 61 with stage C prostate cancer who underwent endocrine therapy at our department between 1985 and 2001. The cause-specific survival rate and PSA recurrence-free rate of stage B patients who underwent endocrine therapy were well, and they will take a good clinical course. Thus, in this stage of prostate cancer, aged patients and patients with complications may be good candidates for endocrine therapy. The cause-specific survival rate and PSA recurrence-free rate in the stage C patients who underwent endocrine therapy were significantly low. In stage C patients, endocrine therapy should be combined early with other methods such as radiotherapy. In the stage B patients who underwent endocrine therapy, PSA and Gleason score appeared to be associated with the cause-specific survival rate and PSA recurrence-free rate.