转移性前列腺癌患者一例综合诊治报道并文献复习

目的探讨转移性前列腺癌不同诊断治疗手段的选择和时机。 方法回顾性分析1例转移性前列腺癌患者的临床资料,复习相关文献并予以讨论。患者,男,65岁,因"耻骨区疼痛伴尿频3月"入院。血PSA>1 000 μg/L。前列腺穿刺活检：双侧均为前列腺腺癌,Gleason评分8分（4+4）,临床分期T4N0M1b。 结果患者接受了去势+比卡鲁胺治疗17个月后进展为去势抵抗性前列腺癌,阿比特龙治疗原发耐药,行基因检测后接受了盆腔放疗和多西他赛化疗,随后病情缓解。 结论对于转移性前列腺癌患者,内分泌治疗是综合治疗的基石,局部放疗和多西他赛化疗有利于缓解临床症状和延长患者生存期,基因检测对个体化治疗方案的制定有一定指导价值。

The diagnosis and treatment of metastatic prostate cancer: a case repot and review of the literature

ObjectiveTo explore the choices and timing of treatment regimens of metastatic prostate cancer. MethodsThe clinical data of a patient of metastatic prostate cancer was reported. The patient, aged 65 years, was admitted to hospital with pubic region pain and urinary frequency and dysuria for 3 months. Serum total prostate specific antigen (PSA) was more than 1 000 μg/L. So prostate biopsy was performed and Gleason score was 4+4, the clinical stage was T4N0M1b. ResultsThe patient underwent combined androgen blockade (castration and bicalutamide) for 17 months. After progressing to castration-resistant prostate cancer (CRPC), the patient showed primary resistance to abiraterone. At the prompt of the genetic test results, the patient received pelvic radiotherapy and docetaxel chemotherapy, showing partial response. ConclusionsFor patients with metastatic prostate cancer, endocrine therapy is the cornerstone of comprehensive treatment. Local radiotherapy and docetaxel chemotherapy are beneficial to alleviate clinical symptoms and prolong the survival of patients. Genetic testing may guide individualized treatment plan.