经尿道前列腺电汽化切除加雄激素阻断治疗晚期前列腺癌

Treatment of late prostatic cancer by prostatectomy after castration and pharmacotherapy (a report of 31 cases)

目的 探讨经尿道前列腺电汽化切除加雄激素阻断治疗晚期前列腺癌的临床疗效.方法 对31例前列腺癌晚期(D)患者采用经尿道前列腺电汽化切除及睾丸切除术,术后3～5 d口服氟他胺做全雄激素阻断以及氟他胺加达菲林的药物去势治疗.结果 随访3～42个月,生存者29例,2例患者生存超过5年,20例超过1年.其中7例骨转移病灶减少,6例骨痛患者治疗后疼痛消失.前列腺特异性抗原(PSA)从术前的75.37 μg/L降至1.34μg/L(术后1个月),3个月后降为0.27μg/L.B超、胸片、骨扫描未见新的转移灶.结论 经尿道前列腺癌电汽化切除加全雄激素阻断治疗晚期前列腺癌具有较好的临床疗效.

Objective To evaluate the clinical effect of the treatment of late prostatic cancer by radical or palliative prostatectomy after castration and endocrine pharmacotherapy. Methods Radical (2 patients) or palliative (5) prostatectomy were performed in 7 patients with late prostatic cancer 3～6 months after castration and pharmacotherapy with Flutamide and DES. Results The obstruction of lower urinary tract was relieved, and the life quality was improved. Improvements in subjective symptoms, objectives signs,maximum flow rate and residual urine were significant. The survival time was lengthened. Mean PSA decreased from 75.37μg/L preoperatively to 1.34μg/L 3～6 months after treament. Bone pain in 6 patients disappeared. Conclusion Radical or palliative prostatectomy after castration and endocrine pharmacotherapy is believed to be safe and effective in relieving the urethal obstruction caused by advanced prostatic cancer.