Philippou Prodromos, Yap Tet, Chinegwundoh Francis
Barts and The London NHS Trust, London, UK.
Urol Int. 2012;88(2):137-44. doi: 10.1159/000332220. Epub 2012 Jan 24.
The experience of a tertiary centre in the management of recurrent prostate cancer after radiotherapy by salvage cryotherapy is presented.
Between February 2006 and August 2008, 19 patients underwent salvage cryotherapy for radiorecurrent prostate cancer. Post-radiotherapy recurrence was confirmed by prostatic biopsy. The 'Phoenix definition' was used to define biochemical failure after salvage cryotherapy.
The mean age at cryotherapy was 69.2 years and the mean time from radiotherapy to cryotherapy was 72.3 months. Patient characteristics prior to cryotherapy included a mean PSA level of 6.84 ng/ml and a median Gleason score of 7. The mean post-cryotherapy follow-up was 33.3 months. The 2-year biochemical disease-free survival rate was 58%. The median post-cryotherapy PSA nadir was 0.20 ng/ml (range 0.005-8.260). There were no procedure-related or cancer-related deaths. Complications included incontinence (10.5%), erectile dysfunction (89%) and fistula formation (5.3%).
The relatively high rates of biochemical response support the use of cryotherapy as a salvage procedure for radiorecurrent prostate cancer.
本文介绍了一家三级医疗中心采用挽救性冷冻疗法治疗放疗后复发性前列腺癌的经验。
2006年2月至2008年8月期间，19例患者接受了针对放射性复发前列腺癌的挽救性冷冻疗法。放疗后复发通过前列腺活检得以证实。采用“凤凰城定义”来界定挽救性冷冻疗法后的生化失败。
冷冻疗法时的平均年龄为69.2岁，从放疗到冷冻疗法的平均时间为72.3个月。冷冻疗法前患者的特征包括平均前列腺特异性抗原（PSA）水平为6.84 ng/ml， Gleason评分中位数为7。冷冻疗法后的平均随访时间为33.3个月。2年无生化疾病生存率为58%。冷冻疗法后PSA最低点的中位数为0.20 ng/ml（范围为0.005 - 8.260）。无与手术相关或与癌症相关的死亡病例。并发症包括尿失禁（10.5%）、勃起功能障碍（89%）和瘘管形成（5.3%）。
相对较高的生化反应率支持将冷冻疗法用作放射性复发前列腺癌的挽救性治疗手段。
