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目的 :探讨晚期前列腺癌综合治疗的方法。 方法 :对 1991年 5月～ 1997年 7月收治的 6 2例晚期前列腺癌 (C期和D期 )病人的治疗结果进行分析。 33例前列腺症状评分 (IPSS) <15的前列腺癌病人 (I组 )行去势术 +缓退瘤。 2 9例IPSS≥ 15的病人 (Ⅱ组 )行经尿道前列腺电切 (TURP) +去势术 +缓退瘤。内分泌治疗期间梗阻症状明显加重者再次行TURP。 结果 :治疗后所有病人的主观症状均较治疗前明显改善 ,最大尿流率 (MFR)增加、剩余尿减少、PSA值明显下降。 34例病人在治疗期间 (治疗 16～ 39个月后 )转变为激素非依赖性前列腺癌 ,经停用缓退瘤 ,改用癌腺治或酮康唑治疗 ,17例 (5 0 % )病人得到不同程度的缓解。 结论 :对IPSS≥ 15的晚期前列腺癌病人 ,TURP可有效地减少尿道梗阻所致的并发症 ,配合内分泌治疗效果良好 ,无严重并发症 ;对激素非依赖性前列腺癌 ,停用缓退瘤 ,改用酮康唑或癌腺治治疗 ,可取得一定疗效。
Objective: To explore the method of comprehensive treatment of advanced prostate cancer. Methods: The results of the treatment of 62 patients with advanced prostate cancer (stage C and D) admitted from May 1991 to July 1997 were analyzed. Thirty-three prostate cancer patients (Group I) with prostate symptom score (IPSS) <15 were treated with castration and withdrawal tumor. Twenty - nine patients with IPSS ≥ 15 (group Ⅱ) underwent transurethral resection of the prostate (TURP) plus castration and delayed withdrawal. Endocrine therapy during obstructive symptoms were significantly worse again TURP line. Results: After treatment, the subjective symptoms of all patients were significantly improved compared with those before treatment. The maximum flow rate (MFR) increased, the residual urine decreased, and the PSA value decreased significantly. Thirty-four patients switched to hormone-independent prostate cancer during treatment (after 16-39 months of treatment), treated with cancer gland or ketoconazole after discontinuation of treatment, and 17 (50%) patients Get different degrees of relief. Conclusion: For patients with advanced prostate cancer with IPSS≥15, TURP can effectively reduce the complications caused by urethral obstruction, with good effect of endocrine therapy, no serious complications; hormone-independent prostate cancer, withdrawal of withdrawal tumor, Switch to ketoconazole or cancer treatment, can achieve a certain effect.