内分泌疗法联合经尿道前列腺电切术治疗伴有重度膀胱出口梗阻的晚期前列腺癌临床观察

Endocrinotherapy Combined with TURP for Treating Advanced Prostate Cancer Accompanied by BOO

目的探讨内分泌疗法联合经尿道前列腺电切术(TURP)治疗伴有重度膀胱出口梗阻(BOO)的晚期前列腺癌(PCa)的临床疗效.方法对17例伴有BOO的晚期前列腺癌患者实施了内分泌疗法(手术和/或药物的全抗雄治疗)联合姑息性经尿道前列腺电切术(TURP).结果随访6～55个月,平均21个月.14例存活,3例因发生远处转移、全身衰竭死亡(分别为术后15、16、21个月).存活病例国际前列腺症状评分(IPSS)、最大尿流率(MFR)均明显改善,血清前列腺特异性抗原(PSA)术后6个月明显下降,差异有统计学意义P<0.05.结论对于伴有严重膀胱出口梗阻的晚期前列腺癌患者,内分泌疗法联合TURP是一种安全、有效的姑息疗法.

Objective To evaluate the clinical effect of endocrinotherapy combined with TURP therapy for advanced prostate cancer accompanied by severe bladder outlet obstruction（BOO）.Method 17 patients with advanced prostate cancer accompanied by BOO were treated with endocrinotherapy（castration and anti-androgen treatmen）t and palliative resection（transurethral resection of the prostate,TURP）.Results The follow-up period ranged from 6 to 55 months（mean 21 months）.14 cases survived.3 cases died from metastasis and systemic failure after 15,16 and 21 months of follow-up.In all survivors,international prostate symptom score（IPSS） and maximum flow rate（MFR） were significantly improved.Serum prostate specific antigen（PSA） level decreased significantly 6 month after operation（P0.05）.Conclusion As for the patients with advanced prostate cancer accompanied by BOO,endocrinotherapy combined with TURP therapy is a safe and effective palliative therapeutic measure.