Chalasani Venu, Martinez Carlos H, Williams Andrew K, Kwan Kevin, Chin Joseph L
Departments of Surgery and Oncology, Divisions of Urology and Surgical Oncology, Schulich School of Medicine & Dentistry, London, ON;
Can Urol Assoc J. 2010 Aug;4(4):E100-2.
The histological changes (both macroscopic and microscopic) in the prostate following the combination of external beam radiotherapy and salvage high intensity focused ultrasound (HIFU) have not been previously described. This article describes the case of a 65-year-old male who presented with recurrent localized prostate cancer after undergoing external beam radiotherapy for low-risk prostate cancer. He was treated with salvage HIFU, and 4 weeks later presented with symptoms and signs consistent with a prostatorectal fistula. During a period of conservative management, his serum prostate-specific antigen levels started rising after having reached a nadir. A radical cystoprostatectomy and repair of fistula were performed after conservative management failed. Histological changes of dense fibrosis were noted in the region where the prostate should have been located. A literature review of the histological findings in the prostate after HIFU is discussed in this article, as well as the available evidence for the management of patients with local failure after the combination of external beam radiotherapy and salvage HIFU.
此前尚未有人描述过外照射放疗联合挽救性高强度聚焦超声（HIFU）后前列腺的组织学变化（包括宏观和微观变化）。本文介绍了一名65岁男性的病例，该患者在接受低风险前列腺癌的外照射放疗后出现复发性局限性前列腺癌。他接受了挽救性HIFU治疗，4周后出现了与前列腺直肠瘘相符的症状和体征。在保守治疗期间，他的血清前列腺特异性抗原水平在降至最低点后开始上升。保守治疗失败后，进行了根治性膀胱前列腺切除术和瘘管修复。在前列腺本应所在的区域发现了致密纤维化的组织学变化。本文讨论了HIFU后前列腺组织学发现的文献综述，以及外照射放疗联合挽救性HIFU后局部治疗失败患者管理的现有证据。
