Eisenberg Michael L, Shinohara Katsuto
Department of Urology, University of California-San Francisco, San Francisco, California 94143-1695, USA.
Urology. 2008 Dec;72(6):1315-8. doi: 10.1016/j.urology.2008.03.040. Epub 2008 Jul 2.
To determine the efficacy of partial cryoablation of the prostate in the salvage setting.
All patients who were treated between April 2004 and September 2007 for recurrent prostate adenocarcinoma after failure of primary radiotherapy by means of partial cryoablation were identified.
Nineteen patients met inclusion criteria; 15 had >6 months' follow-up. Mean age was 71 years. Men received salvage therapy a mean of 6 years after primary radiotherapy. Median follow-up was 18 months (range, 6-33 months). The biochemical recurrence-free survival rate (according to the American Society for Therapeutic Radiology and Oncology definition) was 89%, 67%, and 50% at 1, 2, and 3 years, respectively. One of 10 patients harbored residual carcinoma on routine follow-up biopsy at 1 year, whereas 50% harbored residual benign prostate tissue. Complications included incontinence (1), urethral stricture (1), and urethral ulcer (1).
In properly selected patients with a unilateral focus of disease recurrence after radiotherapy, acceptable oncologic results can be achieved with partial cryoablation of the prostate, with low morbidity.
确定在挽救性治疗中前列腺部分冷冻消融的疗效。
确定了2004年4月至2007年9月期间所有因原发性放疗失败后通过部分冷冻消融治疗复发性前列腺腺癌的患者。
19例患者符合纳入标准;15例有超过6个月的随访。平均年龄为71岁。患者在原发性放疗后平均6年接受挽救性治疗。中位随访时间为18个月(范围6 - 33个月)。根据美国放射肿瘤学会的定义,1年、2年和3年的无生化复发生存率分别为89%、67%和50%。10例患者中有1例在1年的常规随访活检时存在残留癌,而50%存在残留良性前列腺组织。并发症包括尿失禁(1例)、尿道狭窄(1例)和尿道溃疡(1例)。
对于放疗后单侧疾病复发的合适患者,前列腺部分冷冻消融可取得可接受的肿瘤学结果,且发病率低。