高强度聚焦超声联合内分泌综合治疗前列腺癌34例临床分析

Clinic study on treatment of 34 prostatic carcinoma patients with high intensity focused ultrasound combined with endocrine therapy

目的评价应用高强度聚焦超声和内分泌治疗的综合治疗方案在前列腺癌治疗中的临床效果。方法对34例前列腺癌患者联合应用高强度聚焦超声和内分泌治疗,观察和统计治疗前后血前列腺特异性抗原、前列腺体积、前列腺彩超以及前列腺穿刺活检结果的变化,调查治疗后并发症的发生情况。结果 34例患者治疗后血前列腺特异性抗原PSA(14.6±13.1)ng/mL,与治疗前(35.7±14.6)ng/mL相比,具有统计学显著性差异(P<0.05)。前列腺体积治疗前(49.7±21.3)cm3,治疗后(42.1±11.6)cm3,两者无统计学差异(P>0.05)。前列腺再穿刺阴性率68.4%(13/19)患者前列腺再穿刺阴性。26例(76.5%)患者在拔除尿管后出现尿频、尿痛等排尿不适症状。11例(32.3%)出现轻度的血尿。结论联合应用高强度聚焦超声和内分泌治疗的综合治疗方案能有效地降低前列腺癌患者的PSA,临床治疗效果肯定,并发症少,安全性好,是一种比较合理的前列腺癌治疗方案。

Objective To evaluate the clinical efficacy of high intensity focused ultrasound（HIFU）and endocrine therapy for prostatic carcinoma. Methods 34 patients of prostatic carcinoma were treated with HIFU and endocrine therapy. The changes of PSA,the volume of prostate,TURS and prostate biopsy before and after treatment were investigated. The rate of complications was recorded. Results The average level of PSA of 34 patients after treatment was （14.6± 13.1）ng/mL,which was significantly different from the level before treatment （35.7± 14.6）ng/mL. The average level of prostate volume before and after treatment was（49.7 ± 21.3） cm^3 and（42.1 ± 11.6） cm3 , with no significantly difference（P〉0.05）, compared. Prostate biopsy after treatment was negative in 13 patients （68. 4%, 13/19）. Urinary frequency and urodynia occurred in 26 patients （76.5%）. Hematuria occurred in 11 patients（32.3%）. Conclusion HIFU combined with endocrine therapy can decrease PSA significantly. It is a safe and effective therapy for prostatic carcinoma.