Objective: To investigate the clinical effects of integrated traditional Chinese and Western medicine in the treatment of castration-resistant prostate cancer (CRPC).
Methods: A total of 54 CRPC patients were randomly divided into a control and a trial group, all treated by endocrine therapy (oral Bicalutamide at 50 mg per d plus subcutaneous injection of Goserelin at 3.6 mg once every 4 wk) and chemotherapy (intravenous injection of Docetaxel at 75 mg/m2 once every 3 wk plus oral Prednisone at 5 mg bid), while the latter group by Fuyang Huayu Prescription (a Traditional Chinese Medicine ［TCM］ prescription for tonifying yang and dispersing blood stasis) in addition, for a course of 24 weeks. Comparisons were made between the two groups of patients in the level of serum prostate-specific antigen (PSA), Karnofsky physical condition scores, function assessment of cancer therapy-prostate (FACT-P) scores, and TCM symptoms scores before and after 12 or 24 weeks of treatment.
Results: Compared with the baseline, the serum PSA level was significantly decreased after 12 weeks of treatment both in the control (［25.9 ± 39.3］ vs ［20.0 ± 21.1］ μg/L, P <0.05) and in the trial group (［22.1 ± 33.9］ vs ［17.9 ± 19.1］ μg/L, P <0.05), with no statistically significant differences between the two groups (P >0.05). At 24 weeks, however, the PSA levels in the control and trial groups were slightly increased to (23.1 ± 28.4) and (19.6 ± 23.5) μg/L, respectively, with no statistically significant differences in between (P >0.05). Karnofsky, FACT-P and TCM symptoms scores were all markedly improved in the trial group after 12 weeks of treatment (P <0.05) and remained stable at 24 weeks, but not in the control group either at 12 or at 24 weeks (P >0.05).
Conclusions: TCM Fuyang Huayu Prescription combined with endocrine therapy and chemotherapy is effective for CRPC.
目的： 探讨中西医结合治疗去势抵抗性前列腺癌（CRPC）的疗效。方法： 54例CRPC患者随机均分为对照组和治疗组。对照组应用内分泌治疗（口服比卡鲁胺50 mg/d，每4周皮下注射戈舍瑞林3.6 mg ）+化疗（每3周静脉滴注多西他赛75 mg/m2+口服泼尼松5 mg，早晚各1次），治疗组在其基础上加用扶阳化瘀方每日1剂，分早晚服，疗程均为24周。观察两组患者治疗前、治疗12及24周后血清前列腺特异抗原（PSA）水平、体力状况（Karnosky评分）、生活质量（FACT-P）及中医症状评分的变化。结果： 治疗12周后，对照组与治疗组的血清PSA值分别由治疗前的(25.9±39.3) μg/L、(22.1±33.9) μg/L下降至(20.0±21.1) μg/L、(17.9±19.1) μg/L，两组较治疗前均有统计学差异（P<0.05），两组间相比无统计学差异（P>0.05）。治疗24周后，对照组与治疗组血清PSA较治疗3个月后分别小幅上升至(23.1±28.4) μg/L、(19.6±23.5) μg/L，但均无统计学差异（P>0.05）。治疗组在治疗12周后体力状况、生活质量、中医症状评分均得到改善，较治疗前均有统计学差异（P<0.05），治疗24周时较治疗12周时保持稳定；但对照组治疗12周、24周后体力状况、生活质量、中医症状评分均无明显改善（P>0.05）。结论： 扶阳益阴、解毒化瘀方联合化疗对CRPC具有一定的临床疗效，值得临床推广。.
Keywords: chemotherapy; prostate cancer; prostate-specific antigen; integrated traditional Chinese and Western medicine.