激素药物加化疗可延长术后前列腺癌患者寿命

一项新的研究已经表明，前列腺癌患者如果在手术后，药物治疗的同时伴随着化疗治疗，复发风险高的男性能够延长寿命。

这个研究发表在《新英格兰医学期刊》上，发现治疗也可以降低疾病传播的风险。

由英国癌症研究院赞助的伯明翰大学的前列腺癌症专家Nick James教授说，这些结果可能是“实践的改变”。

“在复发和生存方面的好处在临床和统计学上都非常重要”，他补充说。

基于美国的临床试验调查了760名男性，他们的前列腺在诊断后被切除，但是有血液检测作为定义的癌症扩散的风险。

手术之后的患者随之接受化疗以尝试杀死任何可能遗留的癌症细胞。然后大约在接下来的两年时间里，一半接受了叫做bicalutamide抗雄激素的药物，然后另外一半接受安慰剂。

这个研究发现，在试验开始后，接受药物的男性比那些接受安慰剂的有更高一些的机会活过12年。

在接受药物的组中，死于前列腺癌的几率也很低，服用激素治疗的组中，之后死于前列腺的患者是二十分之一，在与接受安慰剂的组相比，二十例死亡中只有不到三例。

“这个重要的实验是个研究在放射治疗清除手术后可能遗留的任何癌细胞之后患者的存活率,”James说。

接受药物的组，癌症扩散的风险同样也降低了。接受比卡鲁胺的20例患者中有3例发现有肿瘤扩散，然而接受安慰剂的20例患者中有5例证明有肿瘤扩散。

由英国癌症研究院赞助的伦敦癌症研究学院的放射治疗专家David Dearnaley教授说这些激素治疗方法的研究成果可能有积极的影响。

他说：“这些药物尚未被许可以这种方式来常规使用，但在某些人中，与目前的治疗方法相比，它可能显地改善生活质量。”

但是关于副作用他也提出了警告：“这种治疗方法的缺点是高水平的乳房胀痛，尽管这可以通过使用抗雌激素治疗或低剂量乳腺放射治疗来减少。

Hormone drug and radiotherapy ‘could extend lives’ of prostate cancer patients after surgery

     Men with a high risk of prostate cancer recurrence could live longer if hormone treatment is given alongside radiotherapy after surgery, a new study has suggested.

The research, published in the New England Journal of Medicine (link is external), found that the treatment could also reduce the risk of the disease spreading.

Professor Nick James, a Cancer Research UK-funded expert in prostate cancer at the University of Birmingham, said the results could be “practice-changing”.

“It shows that the benefits in terms of relapse and survival are both clinically and statistically highly significant,” he added.

    The US-based clinical trial looked at 760 men whose prostate had been removed with surgery after diagnosis, but who had the risk of their cancer spreading, as defined by a blood test.

Following surgery patients received radiotherapy to try to kill any cancer cells that may have been left behind. Then over the next 2 years, half received an anti-androgen drug called bicalutamide while the other half received a placebo.

    The study found that the men who received the drug had a slightly higher chance of being alive 12 years after the start of the trial than those who took the placebo.

    The chance of dying from prostate cancer was also lower in the group who received the drug. 1 in 20 patients in the hormone treatment group later died from prostate cancer, compared to just under 3 in 20 deaths for the placebo group.

“This important trial is the first to study patient survival following radiotherapy given to eradicate any cancer cells that might be left after surgery,” said James.

       The risk of the cancer spreading (metastasis) was also reduced for the group receiving the drug. 3 in 20 of the patients receiving bicalutamide were found to have tumours that had spread, while 5 in 20 patients on the placebo saw their disease spread.

Professor David Dearnaley (link is external), an expert in radiotherapy at The Institute of Cancer Research, London, part-funded by Cancer Research UK, said the findings for the hormone treatment may have positive consequences.

He said: “This drug isn’t yet licensed to be used routinely in this way, but in some men it might significantly improve quality of life compared with current treatments.”

    But he added a note of caution regarding side effects: “The downside of the treatment is a high level of breast swelling (gynaecomastia), although this can be reduced by using anti-oestrogen treatment or low-dose breast radiotherapy.”

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