经直肠高强度聚焦超声治疗局限性前列腺癌的疗效分析

目的观察经直肠高强度聚焦超声(HIFU)治疗局限性前列腺癌的临床疗效。方法将我院2002年12月—2009年10月临床诊断为局限性前列腺癌的85例患者分为低危、中危、高危组,使用Sonablate 500型经直肠HIFU系统行HIFU局部治疗,术后动态观察各组血清前列腺特异性抗原(PSA)变化及前列腺穿刺活检阴性率。结果术后第3个月、第6个月、第12个月的PSA水平较治疗前明显下降(P<0.01)。术后有66例(77.6%)患者PSA最低值≤0.5μg/L,而2年生化无病生存率达到57.8%(48/83)。术后第6个月和第12个月前列腺穿刺阴性率分别为72.9%(62/85)和51.8%(43/83)。结论对于低危和中危局限性前列腺癌,经直肠HIFU治疗可获得良好的肿瘤控制效果,特别对于低危组;而对于高危组局限性前列腺癌,单一的经直肠HIFU治疗肿瘤控制效果不理想。

Transrectal High-Intensity Focused Ultrasound in the Treatment of Localized Prostate Cancer

Objective To evaluate the efficacy of transrectal high-intensity focused ultrasound(HIFU) therapy in the treatment of patients with localized prostate cancer.Methods 85 localized prostate cancer patients admitted to our hospital from December 2002 to October 2009 were divided into lower risk group,intermediate risk group and high risk group.Sonablate 500 was used to perform transrectal HIFU local treatment.Prostate special antigen(PSA) and prostate biopsy negative rate were dynamically observed after operation.Results The levels of PSA were significantly decreased three months,six months and twelve months after operation compared with before operation(P<0.01).66 patients(77.6%) had PSA nadir≤0.5 μg/L,and two-year biochemical free survival rate(BFSR) was 57.8%(48/83).The prostate biopsy negative rate was 72.9%(62/85) and 51.8%(43/83) respectively six months and twelve months after operation.Conclusion This study shows that HIFU can achieve good efficacy for low risk and intermediate risk localized prostate cancer,especially for low risk group.But for high risk prostate cancer,HIFU monotherapy cannot achieve satisfactory result.