经尿道电切联合雄激素全阻断治疗晚期前列腺癌(附34例报告)

TURP combined with TAB in the management of advanced prostatic cancer (report of 34 cases)

目的总结经尿道电切联合雄激素全阻断治疗晚期前列腺癌的经验.方法回顾性分析1998年1月～2003年6月收治的34例晚期前列腺癌病例,C期16例,D期18例.皆先后采用经尿道前列腺电切,双侧睾丸切除,加用内分泌药物治疗(缓退瘤125mg,3次/d.或乙烯雌酚1 mg,3次/d),3例采用了放疗,6例改用磷酸雌二醇氮芥治疗.结果随访6～52个月,平均26个月,所有患者近期排尿通畅,骨痛减轻或消失,直肠指诊前列腺缩小,血清PSA明显下降,复查X线或ECT显示骨转移灶缩小.有9例症状反复,其中3例加用放疗,另6例停用缓退瘤改用磷酸雌二醇氮芥,症状得到控制.带瘤生存2年以上者30例,已死亡8例中3例死于心脑血管意外,5例出现恶病质,全身衰竭死亡.结论综合应用经尿道电切,双侧睾丸切除,加用内分泌药物治疗,以及必要时联用放疗和化疗,能显著改善晚期前列腺癌患者的临床症状和生活质量,延长其寿命.

Objective: To understand the process and efficancy of therapy of transurethral resection of prostate (TURP) combined with total androgen blockade (TAB) in the treatment of advanced prostatic cancer. Methods: From January 1998 to June 2003, 34 patients treated with combined methods, which included TURP and TAB, were studied and reviewed retrospectively. Results: 34 cases were followed up for 6 to 52 months with a means of 26 months. After receiving the combined therapy, the symptoms of bladder outlet obstruction were alleviated, the metastatic bony pains could be relieved, and the prostatic volume and serum prostate special antigene (PSA) were reduced effectively. Conclusions: Patients with advanced prostatic cancer should be treated actively. The therapy of TURP combined with TAB could ease the symptoms and improve the life quality and life terms.