高能聚焦超声联合内分泌疗法治疗前列腺癌

High Intensity Focused Ultrasound Combined with Endocrine Therapy in Treating Prostate Cancer

目的: 探讨高能聚焦超声(HIFU)联合内分泌疗法治疗前列腺癌的疗效. 方法: 对20例前列腺癌患者行HIFU+内分泌治疗,HIFU治疗采用FEP-BY01型高能聚焦超声肿瘤治疗机;内分泌治疗采用手术去势15例,药物去势(LHRH-a)5例,其中14例加用抗雄激素药物.随访时间6～30个月,平均16.5个月. 结果: 治疗前后前列腺体积分别为(36.4± 16.2)、(20.6±11.8) ml(P<0.05);血清前列腺特异性抗原值为(32.2±10.4)、(2.4±0.8) μg/L(P<0.01);国际前列腺症状评分为(20.5±6.5)、(13.6±7.5)分(P<0.05);最大尿流率为(10.6± 6.3)、(14.2±4.6)ml/s(P<0.05).HIFU治疗并发症:轻度血尿5例,局部疼痛8例,尿道狭窄1例. 结论: HIFU联合内分泌疗法治疗前列腺癌并发症少,近期疗效较好.

Objective: To evaluate the clinical efficacy of high intensity focused ultrasound (HIFU) combined with endocrine therapy in the treatment of patients with prostate cancer. Methods: Twenty patients with prostate cancer were treated with extracorporeal HIFU device(model FEP-BY01) and androgen ablation, of whom 15 received orchiectomy and 5 LHRH-a. Fourteen patients of the total number were given flutamide in addition to castration. Results: The mean follow-up was 13.5 months(ranging 6~30).Before and after the treatment, the prostate volume, prostate specific antigen (PSA), international prostate symptom score (IPSS) and maximal flow rate (Qmax) of the patients were ( 36.4± 16.2) ml and ( 20.6± 11.8) ml (P< 0.05), ( 32.2± 10.4) ng/ml and ( 2.4± 0.8) ng/ml(P< 0.01), 20.5± 6.5 and 13.6± 7.5 (P< 0.05), ( 10.6± 6.3) ml/s and ( 14.2± 4.6) ml/s (P< 0.05), respectively. Mild hematuria and pain were noted in 5 and 8 patients respectively, and 1 patient underwent internal urethrotomy with a cold knife because of urethral stricture. Conclusion: HIFU combined with endocrine therapy is effective in the treatment of prostate cancer, with minimal complications.