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目的:探讨经直肠高强度聚焦超声系统(HIFU)治疗PCa的疗效。方法:使用Sonablate500型经直肠HIFU治疗系统,对57例PCa患者进行HIFU治疗,其中局限性PCa27例,晚期PCa30例。在确定生化复发之前,对局限性PCa仅行经直肠HIFU治疗;对于晚期PCa,在行经直肠HIFU治疗的同时,联合应用内分泌治疗。结果:HIFU治疗平均手术操作时间为111(86～153)min,平均术后住院时间为3.2(2～18)d。平均随访时间18(6～30)个月。局限性PCaHIFU治疗后,生化检查阴性率(PSA(4.0μg/L)在治疗后的1、2、3年分别为86%、81%和79%。30例晚期PCa治疗平均8个月(3～24个月)后,26例血清PSA<4.0μg/L(其中20例血清PSA<0.5μg/L)、21例患者前列腺体积缩小>50%。治疗后6个月时与治疗前相比,前列腺体积缩小、PSA水平降低、Qmax增加及IPSS改善差异均有显著性(P<0.05)。HIFU治疗后无严重尿道直肠瘘、尿失禁等并发症发生。结论:经直肠HIFU治疗PCa,安全、有效,并发症少,近期疗效较好,是一种可选择的PCa微创治疗方法。
Objective: To investigate the efficacy of transrectal high-intensity focused ultrasound system (HIFU) in the treatment of PCa. METHODS: Fifty-seven PCa patients underwent HIFU treatment using the Sonablate 500 transthoracic HIFU treatment system, including 27 localized PCa and 30 advanced PCa. Prior to establishing biochemical recurrence, limited PCa is treated only with rectal HIFU; for advanced PCa, endocrine therapy is administered concurrently with rectal HIFU. Results: The average operation time of HIFU treatment was 111 (86-153) min, and the average postoperative hospital stay was 3.2 (2-18) days. The average follow-up time was 18 (6-30) months. Limitations The biochemical negative rates (PSA (4.0 μg / L) were 86%, 81%, and 79% at 1, 2, and 3 years after PCaHIFU treatment, respectively ~ 24 months), serum PSA level was lower than 4.0μg / L in 26 cases (20 cases with serum PSA <0.5μg / L) and prostate volume was reduced by 50% in 21 cases.At 6 months after treatment, , Reduced prostate volume, decreased PSA level, increased Qmax, and improved IPSS (P <0.05) .There was no serious urethral rectal fistula or urinary incontinence complications after HIFU treatment.Conclusion: , Effective, less complications, the recent curative effect is better, is an optional PCa minimally invasive treatment.