高能聚焦超声联合内分泌及放射治疗前列腺癌

Clinical study on treatment of prostatic cancer with high intensity focused ultrasound combined with endocrine and radiotherapy

目的观察高能聚焦超声(HIFU)联合内分泌及外放射治疗前列腺癌(PCa)的疗效和副反应。方法 HIFU联合内分泌及外放射治疗PCa63例,其中Ⅱ期12例,Ⅲ期39例,Ⅳ期12例。术前、术后监测PSA、前列腺体积、最大尿流率(Qmax)变化及副反应发生情况。结果 53例获得12～38个月的随访。术后6个月平均PSA显著降低,为23.3±19.8ng/m1(P<0.01);术后6个月前列腺体积缩小和Qmax提高,较术前差异有显著性(P<0.05);患者l、3年生存率分别为88.9%和65.5%;血尿、尿潴留、尿失禁副反应发生率分别为16.0%、6.0%和3.0%。结论 HIFU联合内分泌及外放射治疗前列腺癌能有效降低PSA,缩小前列腺体积,提高Qmax,且副反应轻微。

Objective To evaluate the efficacy and side-effect of high intensity focused ultrasound（HIFU）combined with endocrine and radiotherapy in treatment of prostate cancer.Methods A total of 63 cases of prostate cancer（12 cases of stage II,39 cases of stage III,12 cases of stage IV）were treated with HIFU combined with endocrine and radiotherapy.The level of serum PSA,the volume of prostate,maximum urine flow rate（Qmax） and side-effect were observed before treatment and 6 months after the combined therapy.Results Fifty-three cases were followed up for 12 months to 38 months.The average PSA level was 23.3±19.8ng/m1 six months after treatment,which was decreased significantly compared with those before treatment（P0.01）.The volume of prostate decreased and Qmax improved compared with those before treatment（P0.05）.One-and 3-years survival rates were 88.9% and 65.5%.The rates of bleeding,urine retention and incontinence were 16.0%,6.0% and 3.0% respectively.Conclusion HIFU combined with endocrine and radiotherapy for treatment of prostate cancer was effective with slight side-effect.