超选择性动脉化疗栓塞术治疗雄激素非依赖性前列腺癌

Superselective arterial chemoembolization for treatment of androgen-independent prostate cancer

目的观察经前列腺动脉化疗栓塞术在治疗雄激素非依赖性前列腺癌(AIPC)中的临床应用。方法 23例AIPC患者随机分为介入组(12例)和对照组(11例),对照组给予雌莫司汀+紫三醇化疗,介入组在给予化疗的同时采用聚乙烯醇(PVA)颗粒栓塞前列腺动脉。结果介入组9例双侧前列腺动脉栓塞成功,3例仅栓塞单侧前列腺动脉;12例前列腺癌引起的血尿消失,双侧栓塞的9例在2个月后血PSA下降>50%,前列腺体积有不同程度缩小,疼痛缓解。对照组11例中7例疼痛减轻,2例肉眼血尿消失,6例PSA下降>50%,前列腺体积无变化。所有患者主要不良反应为恶心、呕吐、发热、会阴部及臀部和下腹部轻度疼痛,经对症处理后缓解或短期内自行缓解。结论超选择性前列腺动脉化疗栓塞对AIPC患者症状的改善和生活质量的提高具有重要意义。

Objective To observe the clinical application of superselective arterial chemoembolization for treatment of androgen-independent prostate cancer（AIPC）.Methods Twenty-three patients with AIPC were randomly divided into 2 groups：Treatment group（12 patients）and control group（11 patients）.In control group,prostatic arterial chemotherapy with paclitaxel and estramustine phosphate was performed,while superselective arterial chemoembolization combined with chemotherapy was performed for the treatment group.Results In the treatment group,both side prostatic arteries were successfully embolized in 9 patients,and single prostatic artery was embolized in 3 patients.Hematuria disappeared in all 12 patients.PSA descended more than 50% in 9 patients whose both side prostatic arteries were treated,while the prostate volume reduced and the pain was released.In control group,pain was released in 7 patients,macroscopic hematuria disappeared in 2 patients and PSA had got down more than 50% in 6 patients,but the prostate volume did not changed.The main side effects included nausea,vomiting,fever,slight pain in perineum,breech and lower abdomen.Conclusion Superselective arterial chemoembolization is effective for relieving the symptom and improving the quality of life in the patients with AIPC.