前列腺癌根治术前的新辅助治疗  

Neoadjuvant Hormonal Ablative Therapy before Radical Prostatectomy

作　　者：高江平[1] 石怀银[2] 张建勇[1] 叶林阳[1] 洪宝发[1] 肖序仁[1] 王晓雄[1] 李炎唐[1] 

机构地区：[1]解放军总医院泌尿外科,北京市100853 [2]解放军总医院病理科,北京市100853

出　　处：《中国肿瘤临床》2003年第10期731-734,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:评价前列腺癌根治性前列腺切除术前内分泌治疗的作用。方法:患者术前接受3个月(仅1例为6个月)的雄激素最大限度阻断治疗(LHRH类似物加非甾体抗雄激素药物)。结果:31例患者平均随访40.3个月(18～72个月)。治疗后PSA均下降,28例(90.3%)降至0.5ng/ml以下,3例(9.7%)未降至0.5ng/ml,其中2例术后PSA升高和局部复发。治疗后临床分期与治疗前相比降低4例(12.9%),升高5例(16.1%)。前列腺切缘肿瘤阳性2例(6.5%)。8例(25.8%)术后20.4个月(6～50个月)出现PSA升高,其中6例(19.4%)术后33.2个月(13～59个月)肿瘤复发,1例死亡。结论:经新辅助内分泌治疗,临床分期和前列腺切缘肿瘤的阳性率降低。Objective:To evaluate the effects of3-month neoadjuvant hormonal treatment in patients treated by radical prostatectomy for locally confined prostate cancer.Methods:A prospective,non-control and open study was performed.Thirty one patients were treated with maximal androgen blockade (LHRH analogue plus nonsteroid antiandrogen agent)prior to radi cal prostatecto my and followed for40.3(18～72)months.Results:After hormonal therapy,PSA level decreased below to0.5ng /ml was seen in28cases(90.3%),but above0.5ng /ml in3cases(9.7%),2of3cases experienced PSA and local recurrence postoperation.Pathological downstaging was seen in4cases(12.9%)and pathological upstaging occurred in5cases(16.1%),respectively.The positive surgical margins were noted in2cases(6.5%).PSA progression oc curred in8cases(25.8%)in20.4(6～50)months after operation,and local recurrence in6cases(19.4%)in33.2(13～59)months postopera tively,respectively.One patient died with tumor.Conclusion:Comparing with the results of direct radical prostatectomy reviewed in articles,this study indicates that these is a trend of pathological downstaging and the lower percentage of patients with positive margins.

关 键 词：前列腺癌 根治性前列腺切除术 新辅助治疗 

分 类 号：R737.25[医药卫生—肿瘤]