High-intensive focused ultrasound in localized prostate cancer.
High-intensive focused ultrasound in localized prostate cancer.
复制标题
高强度聚焦超声治疗局限性前列腺癌。
作者：
C. Chaussy;S. Thüroff
背景和目的
前列腺癌的标准治疗-根治性前列腺切除术-的结果并不完全令人满意。经直肠高强度聚焦超声（HIFU）是一种新的局部治疗方法。我们回顾了我们的经验与高强度聚焦超声姑息局限性前列腺癌。
患者和方法
我们的研究包括65例确诊为前列腺癌且无可检测到的转移的男性，他们不适合进行根治性前列腺切除术。在预防性耻骨上膀胱造口术后，患者在脊髓麻醉下使用Ablatherm 2.32版进行治疗。通过血清前列腺特异性抗原测定、直肠指检和活检监测疗效。平均随访10个月（范围1-18个月）。
结果
无术中或术后死亡，无前列腺癌死亡。仅前列腺活检阳性部分接受治疗的患者中有35%检测到残留癌，而整个腺体接受治疗的患者中有17%检测到残留癌。这些患者在首次治疗后1个月进行再治疗。治疗后前列腺体积平均增加30%，但到3个月时，腺体比原来的大小小10%至20%。三名患者发生并发症继发于直肠壁过热或治疗太接近尿道外括约肌。
结论
高强度聚焦超声具有低发病率、微创、无全身副作用和潜在疗效等优点，是治疗局限性前列腺癌的一种潜在有效的方法。
BACKGROUND AND PURPOSE
The results of the standard treatment for prostate cancer-radical prostatectomy-are not entirely satisfactory. A new local therapy, transrectal high-intensive focused ultrasound (HIFU), has been developed. We reviewed our experience with HIFU for palliation of localized prostate cancer.
PATIENTS AND METHODS
Our series included 65 men with confirmed prostate cancer without detectable metastases who were not suitable candidates for radical prostatectomy. After prophylactic suprapubic cystostomy, the patients were treated using the Ablatherm version 2.32 under spinal anesthesia. The effects were monitored by serum prostate specific antigen assays, digital rectal examination, and biopsy. The mean follow-up is 10 months (range 1-18 months).
RESULTS
There were no intraoperative or postoperative deaths, and there have been no deaths from prostate cancer. Residual cancer was detected in 35% of the patients in whom only biopsy-positive portions of the prostate were treated and 17% of those in whom the entire gland was treated. Retreatment was performed 1 month after the first session in these patients. The prostate volume increased an average of 30% after treatment, but by 3 months, the gland was 10% to 20% smaller than its original size. Three patients suffered complications secondary to overheating of the rectal wall or treatment too close to the external urethral sphincter.
CONCLUSION
The low morbidity, minimal invasiveness, avoidance of systemic side effects, and potentially curative effect make HIFU a potentially useful option for the treatment of localized prostate cancer.
DOI：
10.1001/jama.1992.03480160073037
发表时间：
1992-04
期刊：
JAMA
影响因子：
--
作者：
H. Carter;J. Pearson;E. Metter;L. Brant;L. Brant;Daniel W. Chan;Reubin Andres;Reubin Andres;J. Fozard;P. Walsh
通讯作者：
H. Carter;J. Pearson;E. Metter;L. Brant;L. Brant;Daniel W. Chan;Reubin Andres;Reubin Andres;J. Fozard;P. Walsh