摘要
目的 分析老年高危患者中晚期前列腺癌的治疗.方法 回顾分析1999年7月～2003年12月间收治的18例前列腺癌患者,年龄69～90岁,合并有冠心病5例,心律失常4例,高血压8例,陈旧性心肌梗死1例,糖尿病4例,帕金森病1例.按Whitmore-Jewett分期,C期15例,D期3例.所有患者行经尿道电汽化切除前列腺组织和双侧睾丸切除术,术后间歇雄激素阻断疗法:口服氟他胺,至少6个月以上,伴局部脏器侵犯或腹膜后淋巴结转移行介入化疗3例,放射治疗1例.结果 16例患者获得2～41个月随访,平均24.6个月,1例死亡.术后患者排尿不畅、尿频、尿急症状改善,下尿道梗阻情况明显缓解,最大尿流率(Qmax)平均(7.1±4.9)mL/s上升至(23.7±9.0 )mL/s,前列腺症状评分(I-PSS)平均(19.6±4.4)下降至(5.8±4.2).结论 老年高危患者中晚期前列腺癌行姑息性经尿道前列腺电汽化术,能解除下尿道梗阻,睾丸切除术和间歇雄激素阻断疗法明显抑制肿瘤生长而延长生命.
Objective To study the treatment of moderately and far advanced prostate cancer in the aged. Methods From July 1999 to December 2003, the data of 18 aged patients with moderately and far advanced prostate cancer were reviewed retrospectively. Of the 18 cases, 5 suffered from coronary heart disease, 4 from cardiac arrhythmia, 8 from hypertension, 1 from old myocardial infarction, 4 from diabeters mellitus, and 1 from parkinsonism. Transurethral electrovaporization of prostate (TVP) for prostate cancer and orchiectomy were carried out in all of them. Intermittent androgen supression(IAS) therapy with the use of flutamide was administered postoperatively. Results 16 cases were followed up for 2 to 41 months with a mean of 24.6 months. The subjective symptoms and objective signs were improved; bladder outlet obstruction was relieved; the maximum flow rate had been elevated from 7.1±4.9mL/s to 23.7±9.0mL/s; and I-PSS had been dropped from 19.6±4.4 to 5.8±4.2. Conclusion TVP is a palliative treatment for prostate cancer to relieve bladder outlet obstruction. Orchiectomy and IAS are also effective to inhibit the growth of cancer.
出处
《现代泌尿外科杂志》
CAS
2005年第3期145-147,共3页
Journal of Modern Urology
