经尿道前列腺电汽化加全雄激素阻断治疗合并膀胱出口梗阻的晚期前列腺癌

目的提高合并膀胱出口梗阻的晚期前列腺癌的治疗水平。方法分析22例确诊为合并膀胱出口梗阻晚期前列腺癌病例,同时采取经尿道前列腺电汽化(TUVP)加全雄激素阻断治疗疗效。结果22例手术一次成功,术后3个月随访,IPSS评分平均(9.6±1.5)分,最大尿流率平均(17±2.3)m l,残余尿量平均(12.5±2.3)m l,血清PSA值平均(6.3±2.1)ng/m。l未出现严重并发症。结论TUVP加全雄激素阻断能提高合并膀胱出口梗阻的晚期前列腺癌患者生存质量。     

等离子电切术联合抗雄激素治疗伴膀胱出口梗阻的晚期前列腺癌的疗效观察

目的探析等离子电切术与抗雄激素联合治疗晚期前列腺癌且伴膀胱出口梗阻的临床疗效。方法入选104例伴膀胱出口梗阻的晚期前列腺癌患者,根据入院先后顺序分为2组,观察组54例采用等离子电切术与间断雄激素药物联合治疗,对照组50例仅采用等离子电切术治疗,观察并对比2组治疗前后前列腺体积、前列腺特异性抗原(PSA)、国际前列腺症状(IPSS)评分、残余尿量(RU)、最大尿流率(Qmax)及生活质量评分(QOL)的改变。结果经治疗,观察组前列腺体积(46.5±13.4)cm3显著小于对照组(57.6±13.9)cm3,PSA(1.8±0.6)μg/L显著低于对照组(2.6±0.9)μg/L,IPSS评分(12.8±3.4)分显著低于对照组(15.3±3.5)分,RU(29.6±16.4)ml显著低于对照组(46.2±18.3)ml,Qmax(19.2±4.0)ml/s显著高于对照组(16.3±3.8)ml/s,QOL评分(2.2±1.3)分显著低于对照组(2.8±1.4)分,差异均具有统计学意义(P均<0.05)。结论等离子电切术与抗雄激素联合治疗有助于提高伴膀胱出口梗阻的晚期前列腺癌的临床疗效。     

经尿道前列腺等离子体双极电切联合去势术治疗晚期前列腺癌并膀胱出口梗阻(附25例报告)

目的:探讨经尿道前列腺等离子体双极电切联合去势术治疗晚期前列腺癌所致膀胱出口梗阻(BOO)的效果.方法:对25例晚期前列腺癌合并膀胱出口梗阻患者行经尿道前列腺等离子体双极电切术(TUPKVP)联合去势术治疗.结果:切除前列腺组织21g～103g,平均(42.6±12.8)g,国际前列腺症状评分(IPSS)由术前平均(24.3±3.2)分降至术后平均(8.3±3.7)分(P＜0.01),最大尿流率(Qmax)由术前平均(4.3±2.3)ml/s升至术后平均(19.9±2.1)ml/s(P＜0.01),剩余尿量由术前平均(165.5±51.3)ml降至术后平均(33±12ml),生活质量评分(QOL)由术前平均(5.1±2.0)分降至术后平均(1.8±0.5)分.术后22例平均随访1.5年,1例因尿潴留需再次手术治疗,2例因肿瘤复发转移死亡.结论:TUPKVP安全性高,可有效减轻临床症状,提高生活质量.     

经尿道前列腺电汽化术治疗晚期前列腺癌后尿道梗阻26例

[目的]探讨经尿道前列腺电汽化术(TUVP)对晚期前列腺癌致后尿道梗阻的治疗作用.[方法]对26例晚期前列腺癌致后尿道梗阻患者采用TUVP加双侧睾丸切除术和术后缓退瘤口服治疗.[结果]TUVP切除前列腺组织10g～45g,平均23.23±6.90g.术后均一次性解除后尿道梗阻,最大尿流率从术前6.38±2.04ml/s升至14.15±1.95ml/s,残余尿从术前平均125ml减少至20ml.国际前列腺症状评分(Ⅰ-PSS)从术前29.54±3.19分降至8.54±1.58分.生活质量评分从术前5.35±0.63分降至1.15±0.37分.术前后各参数值比较,P＜0.05.[结论]晚期前列腺癌致后尿道梗阻,在雄激素阻断治疗的同时,加用TUVP治疗,可有效、迅速改善后尿道梗阻症状,对提高患者生活质量有明显作用.     

经尿道等离子电切联合内分泌治疗伴膀胱出口梗阻晚期前列腺癌的临床观察

目的:探讨经尿道等离子电切联合内分泌治疗伴膀胱出口梗阻(BOO)晚期前列腺癌(PCa)的临床疗效。方法:对15例伴BOO的晚期PCa患者行经尿道等离子电切加双侧睾丸切除术和口服氟他胺或吡卡鲁胺的内分泌治疗。结果:15例患者术后下尿路症状均明显减轻,术后12月,国际前列腺症状评分(IPSS)由术前(18-30)分降至(2-12)分(P<0.01)、最大尿流率(Qmax)由术前(9.1±0.5)ml/s增至(19.2±2.2)ml/s(P<0.01)、残余尿量(RV)由术前(220.3±16.5)ml降至(42.4±4.3)ml(P<0.01),前列腺特异性抗原(PSA)由术前(130.8±11.7)ng/ml降至(9.8±0.9)ng/ml(P<0.01)。所有患者均随访至少24月,无死亡病例。结论:晚期伴BOO的PCa患者,经尿道等离子电切联合内分泌治疗是一种安全、有效的姑息性治疗方法。     

TVP联合雄激素阻断治疗晚期前列腺癌合并膀胱出口梗阻的临床观察

前列腺癌晚期患者常伴有严重的膀胱出口梗阻(BOO)症状.我院对此类患者采取经尿道前列腺电汽化术(transufe-thral electrovaporization of the prostatet TVP)+双侧睾丸切除术+抗雄激素内分泌治疗,疗效满意,总结报道如下.     

TVP联合内分泌治疗晚期前列腺癌伴膀胱出口梗阻的近期疗效

目的观察经尿道前列腺电气化术（transurethralelectrov印orizationoftheprostate，TVP）联合内分泌治疗晚期前列腺癌伴膀胱出口梗阻的近期疗效。方法回顾分析采用TVP联合内分泌治疗的48例晚期前列腺癌合并膀胱出口梗阻的临床资料。结果48例晚期前列腺癌均行TVP手术。其中27例术中行睾丸切除，术后予抗雄药物康士得、福至尔或扶他胺治疗。21例未行睾丸切除者，常规应用药物去势（诺雷德、抑那通）联合抗雄药物（康士德、福至尔或扶他胺）。术后3个月复查，所有患者下尿路梗阻症状均有不同程度改善。PSA明显下降，骨转移患者骨痛症状减轻，转移灶稳定。结论TVP联合内分泌治疗伴膀胱出口梗阻的晚期前列腺癌近期疗效满意，是一种有效、安全、可行的治疗方法。     

经尿道前列腺切除术联合间歇性或持续性雄激素阻断治疗晚期前列腺癌的疗效比较

目的探讨经尿道前列腺切除术(TUR-P)联合间歇性或持续性雄激素阻断治疗晚期前列腺癌的疗效。方法选取2007年1月至2010年5月间收治的62例晚期前列腺癌患者,按随机排列表法分为观察组和对照组,每组各31例。观察组采取TUR-P联合间歇性雄激素阻断治疗,对照组采取TUER-P联合持续性雄激素阻断治疗,比较两组患者术后3个月国际前列腺症状评分(IPSS)、生活质量评分(QOL)、残余尿量(RUV)、最大尿流率(Qmax)、3年生存率以及不良反应。结果观察组患者术后IPSS、QOL、3年总生存率分别为(7.01±1.62)分、(1.79±0.46)分和83.9%,对照组患者则分别为(7.92±1.11)分、(2.16±0.34)分和58.1%,观察组明显优于对照组,差异有统计学意义(P<0.05)。观察组患者术后RUV为(25.61±8.21)ml,Qmax为(16.13±2.98)ml/s;对照组患者术后RUV为(26.01±7.51)ml,Qmax为(15.93±3.22)ml/s。观察组患者潮热症、骨质疏松、腹泻不良反应发生率分别为19.35%、12.90%和3.23%,对照组患者分别为61.29%、35.48%和19.35%,两组差异有统计学意义(P<0.05)。结论 TUR-P联合间歇性雄激素阻断治疗晚期前列腺癌能够明显改善患者预后,减少不良反应,值得临床推广。     

经尿道前列腺电切术对前列腺癌合并膀胱出口梗阻患者前列腺症状指标、血清学指标及生存情况的影响

目的 探讨经尿道前列腺电切术（TURP）对前列腺癌合并膀胱出口梗阻患者前列腺症状指标、血清学指标及生存情况的影响。方法 根据治疗方式的不同将60例前列腺癌合并膀胱出口梗阻患者分为内分泌组和联合治疗组,每组30例,内分泌组患者采用常规内分泌治疗,联合治疗组患者在内分泌组的基础上进行TURP治疗,比较两组患者的前列腺症状指标、血清学指标、生活质量、并发症发生情况及生存情况。结果 治疗后1、3个月,联合治疗组患者的国际前列腺症状评分量表（IPSS）评分、残余尿量及血清肌钙蛋白I、超敏C反应蛋白、前列腺特异性抗原水平均低于内分泌组,最大尿流率和生活质量各维度评分均高于内分泌组,差异均有统计学意义（P﹤0.05）。两组患者的并发症总发生率、总生存率比较,差异均无统计学意义（P﹥0.05）。结论 TURP能够有效缓解前列腺癌患者膀胱出口梗阻症状,降低血清肌钙蛋白I、超敏C反应蛋白、前列腺特异性抗原水平,提高患者生活质量,且不影响生存率。     

以尿潴留为首发表现的前列腺癌临床分析（附43例）

目的:回顾分析以尿潴留为首发表现的前列腺癌患者的临床特点。方法:收集我院2001年7月至2014年7月以尿潴留为首发症状的前列腺癌患者43例,均经前列腺穿刺活检确诊。3例患者接受腹腔镜下腹膜外前列腺癌根治术,其余40例患者均接受经尿道前列腺电切术（transurethral resection of prostate,TURP）联合内分泌治疗［（最大限度雄激素阻断（maximal androgen blockade,MAB）］。统计其年龄分布、前列腺特异性抗原（prostate specific antigen,PSA）、直肠指检(digital rectal examination,DRE)阳性率、经直肠前列腺穿刺阳性针数、Gleason评分、骨转移、肿瘤分期、治疗后排尿恢复情况、IPSS评分及1年、3年、5年生存率。结果:43例患者的年龄中位数为69岁;直肠指检阳性率达81.4%（35/43）;PSA＞20 ng/ml者占62.8%（27/43）;经直肠前列腺穿刺（12+X针穿刺法）超过7针以上阳性的占76.7%（33/43）;Gleason评分≥7分占95.3%（41/43）;骨转移患者占76.7%（33/43）;临床分期T3b-T4期占88.4%（38/43）;治疗后6个月全部患者恢复了自主排尿,1年生存率为97.7%,3年生存率为79.1%,5年生存率为55.8%。结论:老年男性发生尿潴留应当考虑有前列腺癌的可能性,该类前列腺癌患者病程往往多为晚期且为高危患者,肿瘤压迫侵犯尿道及膀胱颈是排尿困难的主要原因,经尿道前列腺电切术联合内分泌治疗,可有效解除下尿路梗阻,控制肿瘤进展,提高患者生活质量。     

Using doxasosine and finasteride combination in the treatment of prostate adenoma

The study was made in 2005-2006 of efficacy and safety of combined use of doxasosine and finasteride in patients (n = 50, age 53-83) with symptoms of lower urinary tract dysfunction (LUTD) caused by prostatic adenoma. LUTD severity by IPSS, size of the prostate, maximal and mean urinary flow velocity, functional capacity of the urinary bladder, residual urine, blood pressure, a PSA level, sexual function, were assessed at baseline and after the treatment. Side effects were also registered. Combined treatment with doxasosine plus finasteride significantly lowered both obstructive and irritative LUTD symptoms by IPSS, quality of life improved from 3.4 to 2.3 scores (p < 0.01), maximal urinary flow and mean urinary flow velocity increased from 10.2 to 11.6 ml/s and from 5.4 to 6.1 ml/s, respectively, residual urine reduced from 35.2 to 7.7 ml (p < 0.01). The size of the prostate diminished from 55.8 to 46 cm(3) (p < 0.01). PSA decreased from 2.8 to 1.4 ng/ml. Erectile function did not worsen. Thus, the proposed scheme of combined treatment improves quality of life, voiding; lowers residual urine; is well tolerated; can be recommended as a basic scheme of treatment in patients with a risk of prostatic adenoma progression.     

Retropubic adenomectomy in patients with a high level of prostate-specific antigen after prostatic biopsy

Results of examination and treatment were analysed for 58 patients after retropubic adenomectomy performed from February 2008 to June 2010. The examination protocol included assessment of a total score of the scales IPSS and QoL, parameters of uroflowmetry, total PSA, the size of the prostate, number of prostatic biopsies in a high PSA level. The removed adenomatous tissue was examined histologically. By a PSA level, all the patients were divided into 3 groups. Group 1 - 18 patients with a preoperative PSA level above 10 ng/ml, group 2 - 23 patients with a PSA level from 4 to 10 ng/ml, group 3 - 17 control patients with PSA under 4 ng/ml. Mean age of the examinees was 67.7 +/- 7, 68.7 +/- 7.7, 67.9 +/- 8.9 years (p>0.05), respectively. A mean PSA level was 20.9 (10.3-53), 6.6 (4.1-9.9) and 2.4 (1.3-3.9) ng/ml (p<0.01), respectively. A mean size of the prostate was larger in group 1 patients than in the controls: 127.3 (82-185) cm3 versus 100.7 (81-134) cm3 (p<0.05). Median of the number of transrectal multifocal biopsies was 2 (1-7), 1 (1-2) and 0 in groupl, 2 and 3, respectively. Histological examination of the adenomatous tissue detected prostatic adenocarcinoma in 0, 1(4.3%) and 1(5.9%) patients, respectively, while chronic prostatitis at different stages was diagnosed in 6(33.3%), 7(30.3%) and 7(41.2%) patients, respectively. Thus, the above protocol of examination of patients with prostatic adenoma including measurement of a PSA level, conduction of finger rectal examination followed by prostatic biopsy (transrectal saturation procedure is preferable) provides performance of adenomectomy without a risk to miss a clinically significant prostatic cancer even in a PSA level above 10 ng/ml.     

The suppression of human prostate tumor growth in mice by the intratumoral injection of a slow-release polymeric paste formulation of paclitaxel

Most patients that present in the clinic with prostate cancer have either localized or recurrent postradiotherapy therapy tumors that may be amenable to injectable treatments using slow-release cytotoxic drugs. The objective of this preclinical study was to design an injectable polymeric paste formulation of paclitaxel for intratumoral injection into nonmetastatic human prostate tumors grown s.c. in mice. Paclitaxel was dissolved (10% w/w) in a blend of a biodegradable triblock copolymer of a random copolymer of D,L-lactide and epsilon-caprolactone (PLC) with poly(ethyleneglycol) [PEG; PLC-PEG-PLC] blended with methoxypoly(ethylene glycol) in a 40:60 ratio. Human prostate LNCaP tumors grown s.c. in castrated athymic male mice were injected with 100 microl of this paste at room temperature. Changes in tumor progression were assessed using both serum prostate-specific antigen (PSA) levels and tumor size. Paclitaxel inhibited LNCaP cell growth in vitro in a concentration-dependent fashion with an IC50 of 1 nM. Apoptosis was documented using DNA fragmentation analysis. The paste formulation solidified over a period of 1 h both in vivo and in aqueous media at 37 degrees C as the methoxypoly(ethylene glycol) component partitioned out of the insoluble PLC-PEG-PLC/paclitaxel matrix. The semisolid implant released drug at a rate of about 100 microg/day in vitro. In control mice treated with paste without paclitaxel, serum PSA levels increased from 2-8 ng/ml (mean, 4.3+/-2 ng/ml) to 60-292 ng/ml (mean, 181+/-88 ng/ml), and tumor volume increased from 30 to 1000 mm3. In mice treated with a single 100-microl injection 3 weeks after castration (early-phase treatment group), tumors decreased in volume from a mean of 43+/-19 mm3 to nonpalpable, and PSA levels decreased from a mean of 22+/-8 to 2+/-1 ng/ml by 8 weeks after castration. In mice treated 5 weeks after castration (androgen-independent tumors; late-phase treatment group), tumors decreased in volume from a mean of 233+/-136 mm3 to nonpalpable, and serum PSA decreased from 24+/-8 to 9+/-4 ng/ml. Observed side effects of the treatment were limited to minor ulceration at the needle injection site in paclitaxel-treated mice only. The controlled-release formulation can be injected via 22-gauge needles and is effective in inhibiting LNCaP tumor growth and PSA levels in mice bearing multiple nonmetastatic tumors. Paclitaxel may be an effective therapy for patients with localized tumors recurring after radiotherapy and for some patients with localized tumors who are not candidates for radical treatment.     

Prevalence and correlates of non-tissue prostate cancer diagnosis in the United States

BackgroundGiven the potential complications of prostate biopsies, it is sometimes reasonable in selected patients to make a non-tissue diagnosis of prostate cancer. Little is known about prevalence and factors associated with non-tissue prostate cancer diagnoses in the United States.MethodsWe identified 40 to 99-year-old prostate cancer patients with prostate specific antigen (PSA) ≥20 ng/ml from the 2010–2015 National Cancer Database. Associations were examined between non-tissue prostate cancer diagnosis and age, race, clinical T (cT) and M (cM) categories, PSA, and Charlson-Deyo Comorbidity Index (CCI) with multivariable analyses.ResultsAmong 62,635 patients, 6.2% had a non-tissue diagnosis. The proportion of patients with non-tissue diagnoses increased with advanced age (from 0.9% in ages 40–49 to 44.0% in ages 90–99) and disease stage (cT and cM) and higher CCI and PSA level. Demographic and clinical characteristics statistically significantly associated (all P < .001) with non-tissue diagnosis in adjusted analyses were older age (OR = 24.24, 90 to 99 vs. 60 to 69 years), and higher cT (OR = 4.83; T4 vs. T1), cM (OR = 5.25, M1C vs. M0), CCI (OR = 2.07; 3+ vs. 0), and PSA levels (OR = 3.19, >97.9 ng/ml vs.20 to 39 ng/ml), as well as hormonal therapy (OR = 0.51, with vs. without).ConclusionsNon-tissue diagnosis of prostate cancer, while rare, is not outside normal clinical practice and is strongly associated with advanced patient age, higher clinical stage, multiple comorbidities, and very high PSA levels.     

Diagnosis of infravesical obstruction in patients with benign prostatic hyperplasia

To improve reliability of the diagnosis of infravesical obstruction (IVO) in patients with benign prostatic hyperplasia (BPH), we examined 80 BPH patients (mean age 58.2 +/- 2.1 years). The examination included evaluation of complaints by IPSS, ultrasound investigation with determination of prostatic size and residual urine, and urodynamic tests: uroflowmetry, miction cystometry. We came to the conclusion that symptoms of BPH, size of the gland, amount of residual urine and maximal volumetric miction velocity not always evidence for IVO. To raise reliability of IVO diagnosis we propose the following formula: D1 = 0.818 x S(max) +0.0006 x S(min) +0.215 x Q(max) - 0.478 x Q(aver), where D1 is a discriminant function; S(max) is a maximal linear size of the prostate; S(min) is a minimal linear size of the prostate; Q(max) is maximal volumetric flow rate; Q(aver) is mean volumetric flow rate. If D1 > or = 2.85, IVO is definite. If D1 < or = 2.85, IVO absence is more probable. Thus, the proposed formula provides more reliable diagnosis of IVO in BPH patients than assessment of clinical indices.     

Cumulative Probability of Prostate Cancer Detection Using the International Prostate Symptom Score in a Prostate-specific Antigen-based Population Screening Program in Japan

The International Prostate Symptom Score (IPSS) is often used as an interview sheet for assessing lower urinary tract symptoms (LUTS) at the time of prostate-specific antigen (PSA) testing during population-based screening for prostate cancer. However, the relationship between prostate cancer detection and LUTS status remains controversial. To elucidate this relationship, the cumulative probability of prostate cancer detection using IPSS in biopsy samples from patients categorized by serum PSA levels was investigated. The clinical characteristics of prostate cancer detected using IPSS during screening were also investigated. A total of 1,739 men aged 54-75 years with elevated serum PSA levels who completed the IPSS questionnaire during the initial population screening in Kanazawa City, Japan and underwent systematic transrectal ultrasonography-guided prostate biopsy between 2000 and 2013 were enrolled in the present study. Of the 1,739 men, 544 (31.3%) were diagnosed with prostate cancer during the observation period. The probability of cancer detection at 3 years in the entire study population was 27.4% and 32.7% for men with IPSS≤7 and those with IPSS≥8, respectively; there was no statistically significant difference between groups. In men with serum PSA levels of 6.1 to 12.0ng/mL at initial screening, the probability of cancer detection was significantly higher in men with IPSS≤7 than in those with IPSS≥8. There were no significant differences in clinical characteristics between groups of patients stratified by IPSS. These findings indicate that the use of IPSS for LUTS status evaluation may be useful for prostate cancer detection in the limited range of serum PSA levels.     

高强度聚焦超声对中晚期前列腺癌患者去势治疗后机体免疫指标的影响

背景与目的：高强度聚焦超声(high intensity focused ultrasound,HIFU)可以有效治疗前列腺癌,但肿瘤是一种全身性的疾病,理想的肿瘤治疗方法是能够在不损伤正常组织的同时进行局部肿瘤切除,还能够激活全身的抗肿瘤免疫反应。本研究旨在探讨HIFU治疗对去势治疗后中晚期前列腺癌患者机体免疫指标的影响。方法：行去势治疗的中晚期前列腺癌患者40例,随机分为2组,HIFU组为去势治疗后2周行HIFU治疗(n=20),对照组为单纯去势治疗(n=20),全部经直肠前列腺穿刺病理检查确诊,均为晚期前列腺癌患者,即前列腺特异性抗原(prostate specific antigen,PSA)>20 ng/mL。患者自愿接受HIFU治疗并签署知情同意书。HIFU组与对照组患者平均年龄(72.56±12.38)岁、(75.23±9.35)岁(P=0.446 3);初始PSA为(105.22±20.55)ng/mL、(100.53±18.38)ng/mL(P=0.451 5)。分别取治疗前和治疗后2周前列腺癌患者外周血6 d,检测T淋巴细胞亚群(CD4⁺、CD8⁺、CD4⁺/CD8⁺)和外周血Th细胞因子(IFN-γ、IL-2、IL-4、IL-10)。结果：HIFU组患者治疗后CD4⁺百分比及CD4⁺/CD8⁺比值明显升高;细胞因子IFN-γ、IL-2水平明显增高,而IL-4、IL-10水平明显降低,与治疗前相比差异有统计学意义(P＜0.05),Th1/Th2平衡向Th1漂移。而对照组患者治疗前、后各项免疫指标差异无统计学意义(P＞0.05)。HIFU组与对照组前、后各项免疫指标差值比较差异有统计学意义(P＜0.05)。结论：HIFU治疗可在近期内改善去势治疗后中晚期前列腺癌患者机体免疫功能。     

The efficacy of early adjuvant radiation therapy for pT3N0 prostate cancer: a matched-pair analysis.

PURPOSE: This study examines the effect of adjuvant radiation therapy (RT) on outcome in patients with pT3N0 prostate cancer and makes comparisons to a matched control group. METHODS AND MATERIALS: At our center, 149 patients undergoing radical prostatectomy were found to have pT3N0 prostate cancer, had an undetectable postoperative prostate-specific antigen (PSA) level, and had no immediate hormonal therapy. Fifty-two patients received adjuvant RT within 3 to 6 months of surgery. Ninety-seven underwent radical prostatectomy alone and were observed until PSA failure. From these two cohorts, we matched patients 1:1 according to preoperative PSA (<10 ng/ml vs. >10 ng/ml), Gleason score (<7 vs. > or =7), seminal vesicle invasion, and surgical margin status. Seventy-two patients (36 pairs) were included in the analysis. Median follow-up time was 41 months. We calculated a matched-pairs risk ratio for cumulative risk of PSA relapse (a rise above 0.2 ng/ml). RESULTS: After controlling for the prognostic factors by matching, there was an 88% reduction (95% confidence interval [CI]: 78-93%) in the risk of PSA relapse associated with adjuvant RT. The 5-year freedom from PSA relapse rate was 89% (95% CI: 76-100%) for patients receiving adjuvant RT as compared to 55% (95% CI: 34-79%) for those undergoing radical prostatectomy alone. CONCLUSIONS: These data suggest that adjuvant RT for pT3N0 prostate cancer may significantly reduce the risk of PSA failure as compared to radical prostatectomy alone. Its effect on clinical outcome awaits further follow-up.     

Five-year experience in treating patients with prostatic hyperplasia patients with permixone (Serenoa repens "Pierre Fabre Medicament)

Specialists of the urologic clinic of the I.M. Sechenov Moscow Medical Academy studied effectiveness of lipidosterol extract Serenoa repens (permixon) in 26 patients with prostatic hyperplasia (total prostate-specific antigen was under 4 ng/ml). The trial has been performed from November 1995 up to now. The drug was taken before meal with a small quantity of water in a total daily dose 320 mg twice a day. Initial IPSS values ranged from 8 to 18 scores (mean 11.65 +/- 0.59). Life quality index was 1 to 4 scores (mean 2.46 +/- 0.15). Initial size of the prostate varied from 26 to 63 cm3 (mean 36.23 +/- 1.57 cm3). Maximal urinary flow rate (Qmax) made up 8.7 to 14.6 ml/s (mean 11.83 +/- 0.31 ml/s). Residual urine was initially 0-60 ml (mean 10.58 +/- 2.91 ml). Permixon significantly reduced the disease symptoms and improved quality of life. 5 years of treatment decreased mean IPSS by 8.8 +/- 0.18 (75.5%). QOL--by 1.31 +/- 0.08 (53.3%), size of the prostate--by 10.81 +/- 0.55 cm3 (29.8%). Neither the symptoms nor quality of life became worse for these five years. The size of the prostate reduced in 16, unchanged in 9 and increased only in 1 patient. Qmax was initially under 15 ml/s and rose after the treatment by 4.13 +/- 0.51 ml/s (35%), on the average. Qmax rose above 15 ml/s in 16 patients. Residual urine increased during the treatment in one patient only. Permixon intolerance was not observed. Thus, continuous 5-year therapy with lipidosterol extract Serenoa repens (permixon) proved highly effective and safe in 26 patients with initial or moderate symptoms of prostatic hyperplasia.