新一期英國醫(yī)學(xué)刊物《柳葉刀》刊登研究報告說，在前列腺癌的治療中,，與單獨使用放射療法相比，聯(lián)合使用激素療法和放射療法的療效更好,，可以大幅降低患者的死亡率,。

澳大利亞紐卡斯爾大學(xué)等機構(gòu)的研究人員報告說，他們對800多名前列腺癌癥患者進行了為期10年的跟蹤,。這些患者在治療上被分為3組,，第1組只用放射療法，第2組在放射療法的基礎(chǔ)上加上3個月的激素療法,，第3組則是在放射療法的基礎(chǔ)上加上6個月的激素療法,。

結(jié)果顯示，在10年跟蹤期間,，第2組患者的死亡率與第1組相比略有下降,，但第3組患者的死亡率則大幅下降，與第1組相比要低一半,。

研究人員說,，這項研究提供了兩個重要信息，即在前列腺癌的治療中聯(lián)合使用激素療法和放射療法的確效果更好,，且激素療法應(yīng)持續(xù)6個月才會有較好效果,。

放射療法是一種常見的療法，它用X射線來殺死癌變組織,。而激素療法主要用于與性別有關(guān)的疾病,。男性的前列腺癌常與雄性激素有關(guān)，因此用藥物控制雄性激素有助于治療前列腺癌,。（生物谷Bioon.com）

生物谷推薦原文出處：

The Lancet Oncology, doi:10.1016/S1470-2045(11)70063-8

Short-term neoadjuvant androgen deprivation and radiotherapy for locally advanced prostate cancer: 10-year data from the TROG 96.01 randomised trial

Original TextProf James W Denham MD a , Allison Steigler BMath a, Prof David S Lamb FRANZCR b, Prof David Joseph FRANZCR c, Sandra Turner FRANZCR d, John Matthews FRANZCR e, Chris Atkinson FRANZCR f, John North FRANZCR g, David Christie FRANZCR h, Prof Nigel A Spry FRANZCR c, Keen-Hun Tai FRANZCR i, Chris Wynne FRANZCR f, Prof Catherine D'Este PhD j

Summary

Background

The TROG 96.01 trial assessed whether 3-month and 6-month short-term neoadjuvant androgen deprivation therapy (NADT) decreases clinical progression and mortality after radiotherapy for locally advanced prostate cancer. Here we report the 10-year results.

Methods

Between June, 1996, and February, 2000, 818 men with T2b, T2c, T3, and T4 N0 M0 prostate cancers were randomly assigned to receive radiotherapy alone, 3 months of NADT plus radiotherapy, or 6 months of NADT plus radiotherapy. The radiotherapy dose for all groups was 66 Gy, delivered to the prostate and seminal vesicles (excluding pelvic nodes) in 33 fractions of 2 Gy per day (excluding weekends) over 6·5—7·0 weeks. NADT consisted of 3·6 mg goserelin given subcutaneously every month and 250 mg flutamide given orally three times a day. NADT began 2 months before radiotherapy for the 3-month NADT group and 5 months before radiotherapy for the 6-month NADT group. Primary endpoints were prostate-cancer-specific mortality and all-cause mortality. Treatment allocation was open label and randomisation was done with a minimisation technique according to age, clinical stage, tumour grade, and initial prostate-specific antigen concentration (PSA). Analysis was by intention-to-treat. The trial has been closed to follow-up and all main endpoint analyses are completed. The trial is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12607000237482.

Findings

802 men were eligible for analysis (270 in the radiotherapy alone group, 265 in the 3-month NADT group, and 267 in the 6-month NADT group) after a median follow-up of 10·6 years (IQR 6·9—11·6). Compared with radiotherapy alone, 3 months of NADT decreased the cumulative incidence of PSA progression (adjusted hazard ratio 0·72, 95% CI 0·57—0·90; p=0·003) and local progression (0·49, 0·33—0·73; p=0·0005), and improved event-free survival (0·63, 0·52—0·77; p<0·0001). 6 months of NADT further reduced PSA progression (0·57, 0·46—0·72; p<0·0001) and local progression (0·45, 0·30—0·66; p=0·0001), and led to a greater improvement in event-free survival (0·51, 0·42—0·61, p<0·0001), compared with radiotherapy alone. 3-month NADT had no effect on distant progression (0·89, 0·60—1·31; p=0·550), prostate cancer-specific mortality (0·86, 0·60—1·23; p=0·398), or all-cause mortality (0·84, 0·65—1·08; p=0·180), compared with radiotherapy alone. By contrast, 6-month NADT decreased distant progression (0·49, 0·31—0·76; p=0·001), prostate cancer-specific mortality (0·49, 0·32—0·74; p=0·0008), and all-cause mortality (0·63, 0·48—0·83; p=0·0008), compared with radiotherapy alone. Treatment-related morbidity was not increased with NADT within the first 5 years after randomisation.

Interpretation

6 months of neoadjuvant androgen deprivation combined radiotherapy is an effective treatment option for locally advanced prostate cancer, particularly in men without nodal metastases or pre-existing metabolic comorbidities that could be exacerbated by prolonged androgen deprivation.

Funding

Australian Government National Health and Medical Research Council, Hunter Medical Research Institute, AstraZeneca, and Schering-Plough.