Departments of Urology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
Department of Urology, Tokai University Hachioji Hospital, 1838 Ishikawa-machi, Hachioji, Tokyo, 192-0032, Japan.
Int J Clin Oncol. 2020 Oct;25(10):1844-1853. doi: 10.1007/s10147-020-01723-9. Epub 2020 Jun 17.
We evaluated clinical outcomes of region target focal therapy with high-intensity focused ultrasound (HIFU) for the localized prostate cancer (PCa) based on magnetic resonance imaging-based biopsy and systematic prostate biopsy for Asian.
We prospectively recruited patients with localized PCa, located their significant tumors using MRI-transrectal ultrasound (TRUS) elastic fusion image-guided transperineal prostate biopsy and 12-cores transperineal systematic biopsy, and focally treated these regions in which the tumors were located in the prostate using HIFU. Patients' functional and oncological outcomes were analyzed prospectively.
We treated 90 men (median age 70 years; median PSA level 7.26 ng/ml). Catheterization was performed within 24 h after the treatment in all patients. Biochemical disease-free rate was 92.2% during 21 months follow-up when use of Phoenix ASTRO definition. In follow-up biopsy, significant cancer was detected in 8.9% of the patients in un-treated areas. Urinary functions, including international prostate symptom score (IPSS) (P < 0.0001), IPSS quality of life (QOL) (P = 0.001), overactive bladder symptom score (OABSS) (P < 0.0001), EPIC urinary domain (P < 0.0001), maximum urinary flow rate (P < 0.0001), and IIEF-5 (P = 0.001), had significantly deteriorated at 1 month after treatment, but improved to preoperative levels at 3 or 6 months. Rates of erectile dysfunction and ejaculation who had the functions were 86% and 70%, respectively, at 12 months after treatment.
The present treatment for Asian would have similar oncological and functional outcomes to those in previous reports. Further large studies are required to verify oncological and functional outcomes from this treatment for patients with localized PCa.
我们评估了基于磁共振成像引导经直肠超声（TRUS）弹性融合图像引导经会阴前列腺穿刺活检和 12 针经会阴系统穿刺活检对亚洲局限性前列腺癌（PCa）患者进行区域靶向聚焦治疗的临床疗效。
我们前瞻性地招募了局限性 PCa 患者，使用 MRI-TRUS 弹性融合图像引导经会阴前列腺穿刺活检和 12 针经会阴系统穿刺活检定位其显著肿瘤，并使用高强度聚焦超声（HIFU）对这些肿瘤所在的区域进行局部治疗。前瞻性分析患者的功能和肿瘤学结果。
我们共治疗了 90 例男性（中位年龄 70 岁；中位 PSA 水平 7.26ng/ml）。所有患者均在治疗后 24 小时内进行导尿。当使用凤凰 ASTRO 定义时，21 个月的随访期间生化无病生存率为 92.2%。在随访活检中，未治疗区域的患者中有 8.9%发现有显著癌症。尿功能，包括国际前列腺症状评分（IPSS）（P<0.0001）、IPSS 生活质量评分（QOL）（P=0.001）、膀胱过度活动症症状评分（OABSS）（P<0.0001）、EPIC 尿域评分（P<0.0001）、最大尿流率（P<0.0001）和 IIEF-5（P=0.001），在治疗后 1 个月显著恶化，但在 3 或 6 个月时恢复到术前水平。治疗后 12 个月，有勃起功能的患者勃起功能障碍和射精发生率分别为 86%和 70%。
目前对亚洲人的治疗在肿瘤学和功能结果方面与以往报道相似。需要进一步的大型研究来验证这种治疗方法对局限性 PCa 患者的肿瘤学和功能结果。
