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目的观察高能聚焦超声(HIFU)联合内分泌及外放射治疗前列腺癌(PCa)的疗效和副反应。方法 HIFU联合内分泌及外放射治疗PCa63例,其中Ⅱ期12例,Ⅲ期39例,Ⅳ期12例。术前、术后监测PSA、前列腺体积、最大尿流率(Qmax)变化及副反应发生情况。结果 53例获得12～38个月的随访。术后6个月平均PSA显著降低,为23.3±19.8ng/m1(P<0.01);术后6个月前列腺体积缩小和Qmax提高,较术前差异有显著性(P<0.05);患者l、3年生存率分别为88.9%和65.5%;血尿、尿潴留、尿失禁副反应发生率分别为16.0%、6.0%和3.0%。结论 HIFU联合内分泌及外放射治疗前列腺癌能有效降低PSA,缩小前列腺体积,提高Qmax,且副反应轻微。
Objective To observe the efficacy and side effects of high energy focused ultrasound (HIFU) combined with endocrine and external radiation in the treatment of prostate cancer (PCa). Methods HIFU combined with endocrine and external radiotherapy in 63 cases of PCa, including 12 cases of stage Ⅱ, 39 cases of stage Ⅲ, 12 cases of stage Ⅳ. Preoperative and postoperative monitoring PSA, prostate volume, maximum flow rate (Qmax) changes and the incidence of side effects. Results 53 cases were followed up for 12 to 38 months. The mean PSA was significantly lower at 6 months after operation (23.3 ± 19.8ng / m1, P <0.01). The volume of prostate gland and Qmax increased 6 months after operation, which was significantly different from that before operation (P <0.05) The 3-year survival rates were 88.9% and 65.5% respectively. The incidences of hematuria, urinary retention and urinary incontinence were 16.0%, 6.0% and 3.0% respectively. Conclusion HIFU combined with endocrine and external radiotherapy for prostate cancer can effectively reduce the PSA, reduce the prostate volume, increase Qmax, and minor side effects.