高强度超声聚能系统治疗激素难治性前列腺癌临床疗效观察  

High-intensity focused ultrasound in treatment of hormone-refractory prostate cancer

作　　者：赵永斌[1] 胡卫列[1] 吕军[1] 邓志雄[1] 张利朝[1] 邱晓拂[1] 肖远松[1] 刘俊[1] 张长征 

机构地区：[1]广州军区泌尿外科研究所广州军区广州总医院泌尿外科,广州510010

出　　处：《临床泌尿外科杂志》2008年第10期769-771,共3页Journal of Clinical Urology

基　　金：广东省科技计划项目(编号:2004B30301013);广东省卫生厅科研基金项目(编号:A2004478)

摘　　要：目的:探讨经直肠高强度聚焦超声(high-intensity focused ultrasound,HIFU)治疗激素难治性前列腺癌的有效性及安全性。方法:采用美国Focus Surgery公司生产的第三代HIFU Sonablate-500型治疗仪,对22例激素难治性前列腺癌患者进行治疗。根据直肠指检和经直肠前列腺B超检查前列腺肿块大小、血清PSA、ECT骨扫描等将疗效分为完全反应(CR)、部分反应(PR)、病情稳定(SD)、病情恶化(PD)。主观症状根据骨痛、排尿异常、血尿等症状的变化分为症状消失、症状改善、症状平稳、症状加剧。结果:经HIFU治疗,CR6例,占27.3%(6/22);PR11例,占50.0%(11/22);SD4例,占18.2%(4/22);PD1例,占4.5%(1/22)。总有效率(CR+PR)达到77.3%(17/22)。主观症状消失9例,占40.9%(9/22);症状改善6例,占27.3%(6/22);症状稳定3例,占13.6%(3/22);症状加剧4例,占18.2%(4/22)。主观症状总改善率(症状消失+症状改善)达到68.2%(15/22)。3例伴有血尿者均控制良好。术后并发症:3例发生附睾炎,无尿道狭窄、尿失禁、阳痿、尿道直肠瘘并发症发生。结论:HIFU对激素难治性前列腺癌的治疗有效、安全,为微创治疗激素难治性前列腺癌提供了新的途径。Objective：To investigate the safety and effectiveness of transrectal high-intensity focused ultrasound （HIFU） in treatment of hormone-refractory prostate cancer（HRPC）. Methods：The third generation HIFU device called the Sonablate-500^TM（Focus Surgery, Indianapolis, IN, USA） was used. 22 cases of HRPC were treated with transrectal HIFU device. Depended on digital rectal examination,Transrectal Ultrasound,PSA and ECT etc , they were divided into four grades： complete response （CR）, partial response （PR）, stabilization of disease （SD） and progression of disease （PD）. The subjective symptom was divided into four grades （curative, improving, smooth, aggravated） depend on bone ache,paruria, blood urine. Results：After treating with HIFU, CR was 6（27.3%）, PR was 11（50%）, SD was4（18.2%）, PD was 1（4.5%）. CR＋PR were 17（77.3%）. In subjective symptom, curative was 9（40.9%）, improving was 6（27.3%）, smooth was 3（13.6%）, aggravated was 4（18.2%）. The curative ＋ improving were 15（68.2%）. 3 cases with blood urine were controlled. Postoperative complications occurred in 3 cases, which was epididymitis. The urethrostenosis, uroclepsia, ED, urethro rectal were not happened. Conclusions： HIFU is safe and effective treatment for prostatic diseases with minimally invasive.

关 键 词：高强度聚焦超声 难治性前列腺癌 前列腺 

分 类 号：R697.3[医药卫生—泌尿科学]