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目的提高对高危局限性前列腺癌个体化综合诊疗方式的认识。方法对1例高危局限型前列腺癌患者的临床资料及诊疗方案进行回顾、分析,并进行相关文献复习。此患者先后经历了最大限度雄激素阻断治疗、高强度聚焦超声前列腺消融、三维适型调强放疗、经直肠穿刺125I粒子植入、多西他赛联合强的松、口服磷酸雌莫司汀化疗和阿比特龙抗雄等综合治疗方式。结果患者于2006年9月查PSA 158.69ng/mL,经直肠前列腺穿刺病理确诊为前列腺低分化腺癌,Gleason评分5+4=9分,经综合治疗后,目前已进展为去势抵抗性前列腺癌,伴全身多发骨转移,予再次多西他赛联合强的松3周化疗方案,目前PSA较化疗前显著降低,体能状态较好,骨痛不适症状明显好转,仍在随访治疗中。结论对高危局限性前列腺癌患者采用个体化综合治疗策略,能推迟肿瘤的进展,提高患者的生存质量,值得临床进一步探讨。
Objective To raise awareness of the individualized comprehensive treatment of high-risk localized prostate cancer. Methods The clinical data and diagnosis and treatment plan of 1 high-risk localized prostate cancer were retrospectively analyzed and reviewed. This patient has undergone maximal androgen blockade, high-intensity focused ultrasound ablation of the prostate, three-dimensional modulated IMRT, transplanted 125I particles, docetaxel plus prednisone, and oral estramustine phosphate Chemotherapy and abiraterone anti-male and other comprehensive treatment. Results In September 2006, the patients were examined for 158.69 ng / mL of PSA, diagnosed as poorly differentiated adenocarcinoma of the prostate by rectal prostatic biopsy, and Gleason score of 5 + 4 = 9. After comprehensive treatment, it has progressed to castration-resistant prostate Cancer with multiple multiple bone metastases, once again docetaxel combined prednisone 3 weeks of chemotherapy, the current PSA significantly lower than before chemotherapy, physical fitness is good, significantly improved the symptoms of bone pain, are still under follow-up treatment. Conclusion The individualized comprehensive treatment strategy for high-risk localized prostate cancer patients can delay the progression of the tumor and improve the quality of life of the patients, which deserves further clinical study.