摘要
目的观察经尿道铥激光前列腺切除术联合雄激素全阻断治疗晚期前列腺癌合并膀胱出口梗阻的临床疗效。方法选择2010年8月-2012年4月在同济大学附属第十人民医院行铥激光前列腺切除术联合雄激素全阻断治疗的晚期前列腺癌患者,观察患者手术前、后总前列腺特异性抗原(tPSA),最大尿流率(MFR),残余尿(RV),国际前列腺症状评分(IPSS)和生活质量评分(QOL)的变化或进展情况。结果术后1、6、12个月,患者的tPSA水平、IPSS评分、QOL评分及RV均较术前显著降低(P值均<0.05),MFR较术前显著增高(P<0.05)。术后12个月,患者的tPSA水平显著高于术后6个月(P<0.05),RV显著高于术后1、6个月(P<0.05)。6例骨转移患者在随访期间均未出现新转移灶。1例患者随访至6个月,骨扫描提示T4椎体转移。结论 经尿道铥激光前列腺切除术联合雄激素全阻断治疗晚期前列腺癌合并膀胱出口梗阻简捷、安全、有效,是晚期前列腺癌姑息性治疗的一种重要方法。
Objective To investigate the efficacy of thulium laser resection combined with antiandrogen therapy in treatment of patients with advanced prostatic cancer accompanied by bladder outlet obstruction. Methods We retrospectively reviewed the clinical data of 49 patients diagnosed as advanced prostatic cancer accompanied by bladder outlet obstruction, who were treated in our hospital from August 2010 to April 2012 by thulium laser resection of prostate and antiandrogen therapy. The changes of total prostate specific antigen （tPSA）, maximum urinary flow rate （MFR）, residual urine volume （RV）, international prostate symptom score （IPSS）, and quality of life （QOL） were observed before and after the operation. Results Compared with preoperative ones, tPSA, IPSS, QOL score and RV were significantly decreased, and MFR were significantly increased 1, 6 and 12 months postoperatively （P0.05）. tPSA at 12 months posoperatively was significantly higher than that at 6 months postoperatively （P0.05）. RV levels at 12 months postoperatively were significantly higher than that at month 1 and 6 （P0.05）. Six patients with bone metastasis had no new metastases during follow-up. Bone scan suggested T4 vertebral metastasis in one patient at the 6th month of follow-up. Conclusion Thulium laser resection of prostate combined with antiandrogen therapy is simple, safe and effective for the patients with advanced prostatic cancer accompanied by bladder outlet obstruction. It is an important palliative therapy for advanced prostatic cancer.
出处
《上海医学》
CAS
CSCD
北大核心
2012年第5期389-391,共3页
Shanghai Medical Journal
关键词
晚期前列腺癌
铥激光
膀胱出口梗阻
Advanced prostatic cancer
Thulium laser
Bladder outlet obstruction
