晚期前列腺癌的诊断与治疗(附84例报告)

Diagnosis and treatment of advanced prostatic cancer(report of 84 cases)

目的提高晚期前列腺癌的诊断和治疗效果。方法回顾性分析采用睾丸切除术治疗84例晚期前列腺癌患者资料。其中22例行经尿道前列腺电切,3例前列腺癌根治治疗,3例介入化疗。结果78例患者获得3个月至5年随访,1例死亡。46例患者获得5年随访,19例生存。术后患者排尿不畅、尿频、尿急症状改善,下尿道梗阻情况明显缓解,血清前列腺特异性抗原迅速降低,骨痛缓解。结论晚期前列腺癌睾丸切除术和雄激素阻断疗法明显抑制肿瘤生长而延长生命,姑息性经尿道前列腺电汽化术,能解除下尿道梗阻。

Objective To improve the diagnosis and treatment of advanced prostatic cancer. Methods Eighty-four cases of late-stage prostatic cancer were reviewed in this study. All the patients underwent bilateral orchiectomy and endocrinal therapy （flutamide）; 22 cases with severe ureteric obstruction were treated by transurethral resection of prostate; 3 cases underwent radical protatetomy; 3 cases were treated by interventional chemotherapy. Results 78 cases were followed up for 3-24 months. 46 cases were followed up for 5 years. The subjective symptoms and objective signs were improved; the obstruction of bladder outlet and bone pain were relieved to different extent; PSA decreased and the life quality was improved apparently. Conclusion Bilateral orchiectomy and endocrinal therapy were effective to inhibit the growth of cancer. TURP can relieve bladder outlet obstruction.