There are estimated to be 220800 cases of prostate cancer diagnosed in 2015, making up 26% of all cancer diagnoses. Fortunately, adenocarcinoma of the prostate is often a highly treatable malignancy. Even though the m...There are estimated to be 220800 cases of prostate cancer diagnosed in 2015, making up 26% of all cancer diagnoses. Fortunately, adenocarcinoma of the prostate is often a highly treatable malignancy. Even though the majority of prostate cancer patients present with localized disease, prostate cancer still accounts for over 27000 deaths a year. There is a subset of patients thatare likely to recur after locoregional treatment that is thought of as a "high-risk" population. This more aggressive subset includes patients with clinical stage greater than T2 b, Gleason score greater than 7, and prostate specific antigen greater than 20 ng/d L. The rate of biochemical relapse in this high risk group is 32%-70% within five years of definitive focal therapy. Given these discouraging outcomes, attempts have been made to improve cure rates by radiation dose escalation, addition of androgen depravation therapy, and addition of chemotherapy either sequentially or concurrently with radiation. One method that has been shown to improve clinical outcomes is the addition of chemotherapy to radiotherapy for definitive treatment. Concurrent chemoradiation with 5-fluorouracil, estramustine phosphate, vincristine, docetaxel, and paclitaxel has been studied in the phase I and/or II setting. These trials have identified the maximum tolerated dose of chemotherapy and radiation that can be safely delivered concurrently and established the safety and feasibility of this technique. This review will focus on the addition of concurrent chemotherapy to radiotherapy in the definitive management of high-risk prostate cancer.展开更多
目的探讨经尿道柱状球囊前列腺扩裂术(transurethral columnar ballon dilation of prostate,TUCBDP)治疗高龄高危良性前列腺增生的临床疗效。方法从2016年10月至2018年12月,我院采用TUCBDP手术方式治疗高危高龄的BPH患者20例,观察患者...目的探讨经尿道柱状球囊前列腺扩裂术(transurethral columnar ballon dilation of prostate,TUCBDP)治疗高龄高危良性前列腺增生的临床疗效。方法从2016年10月至2018年12月,我院采用TUCBDP手术方式治疗高危高龄的BPH患者20例,观察患者手术时间(min)、手术出血量(mL)、围手术期并发症,以及两组患者术前与术后1个月国际前列腺症状评分(International Prostate Symptoms Scales,IPSS)、生活质量评分(Quality of Life,QOL)、最大尿流率(the maximum of urine quotiety,QmaX)、残余尿量(residual urine volume,RUV)。结果患者术后1个月国际前列腺症状评分(I-PSS)、生活质量评分(QOL)、术后最大尿流率(QmaX)、残余尿量(RUV)与术前患者各项指标对比差异有统计学意义(P<0.05)。结论。TUCBDP能明显改善前列腺增生的I-PSS、QOL、QmaX、RUV方面等,对于年老体弱、合并多种合并症的高龄高危患者是一种合理,安全有效的手术方法。展开更多
文摘There are estimated to be 220800 cases of prostate cancer diagnosed in 2015, making up 26% of all cancer diagnoses. Fortunately, adenocarcinoma of the prostate is often a highly treatable malignancy. Even though the majority of prostate cancer patients present with localized disease, prostate cancer still accounts for over 27000 deaths a year. There is a subset of patients thatare likely to recur after locoregional treatment that is thought of as a "high-risk" population. This more aggressive subset includes patients with clinical stage greater than T2 b, Gleason score greater than 7, and prostate specific antigen greater than 20 ng/d L. The rate of biochemical relapse in this high risk group is 32%-70% within five years of definitive focal therapy. Given these discouraging outcomes, attempts have been made to improve cure rates by radiation dose escalation, addition of androgen depravation therapy, and addition of chemotherapy either sequentially or concurrently with radiation. One method that has been shown to improve clinical outcomes is the addition of chemotherapy to radiotherapy for definitive treatment. Concurrent chemoradiation with 5-fluorouracil, estramustine phosphate, vincristine, docetaxel, and paclitaxel has been studied in the phase I and/or II setting. These trials have identified the maximum tolerated dose of chemotherapy and radiation that can be safely delivered concurrently and established the safety and feasibility of this technique. This review will focus on the addition of concurrent chemotherapy to radiotherapy in the definitive management of high-risk prostate cancer.
文摘目的探讨经尿道柱状球囊前列腺扩裂术(transurethral columnar ballon dilation of prostate,TUCBDP)治疗高龄高危良性前列腺增生的临床疗效。方法从2016年10月至2018年12月,我院采用TUCBDP手术方式治疗高危高龄的BPH患者20例,观察患者手术时间(min)、手术出血量(mL)、围手术期并发症,以及两组患者术前与术后1个月国际前列腺症状评分(International Prostate Symptoms Scales,IPSS)、生活质量评分(Quality of Life,QOL)、最大尿流率(the maximum of urine quotiety,QmaX)、残余尿量(residual urine volume,RUV)。结果患者术后1个月国际前列腺症状评分(I-PSS)、生活质量评分(QOL)、术后最大尿流率(QmaX)、残余尿量(RUV)与术前患者各项指标对比差异有统计学意义(P<0.05)。结论。TUCBDP能明显改善前列腺增生的I-PSS、QOL、QmaX、RUV方面等,对于年老体弱、合并多种合并症的高龄高危患者是一种合理,安全有效的手术方法。
