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高强度聚焦超声(Sonablate)治疗前列腺癌:台湾的初步结果。

High-Intensity Focused Ultrasound (Sonablate) for Prostate Cancer: Preliminary Outcomes in Taiwan.

机构信息

Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.

Department of Internal Education, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.

出版信息

Ann Surg Oncol. 2023 Dec;30(13):8764-8769. doi: 10.1245/s10434-023-14250-4. Epub 2023 Sep 11.

Abstract

PURPOSE

We reported preliminary outcomes of high-intensity focused ultrasound (HIFU) [Sonablate] in the combination of transurethral resection of the prostate for localized prostate cancer in Taiwan.

METHODS

Seventy-seven patients using Sonablate HIFU for localized prostate cancer were enrolled in this study from April 2021 to December 2022. Prostate-specific antigen biochemical recurrence, International Index of Erectile Function (IIEF)-5 scores, International Prostate Symptom Score (IPSS), quality of life (QoL) scores, and postoperative complications were recorded during follow-up.

RESULTS

Overall, 19.5% of patients were low-risk, 36.4% were intermediate-risk, and 44.1% were high-risk according to the D'Amico risk classification. The median follow-up was 12.09 ± 5.85 months, and the biochemical-free survival rates for the low-, intermediate-, and high-risk groups were 100% (15/15), 96.4% (27/28), and 79.4% (27/34), respectively. Four patients (5.2%) received salvage radiotherapy and all maintained biochemical-free survival. The mean IPSS and QoL scores before versus after HIFU were 10.4 versus 6.8 (p = 0.003) and 3.2 versus 3.0 (p = 0.096), respectively. There was no statistically significant change in preoperative and postoperative IIEF scores (20.6 vs. 19; p = 0.062) in patients who had an IIEF score of >15 at baseline and received nerve-sparing procedures (subtotal ablation).

CONCLUSIONS

The results of Sonablate HIFU in Taiwan indicated adequate short-term cancer control, excellent potency, and continence preservation. HIFU can achieve improvement of IPSS with low complication rates.

摘要

目的

我们报道了高强度聚焦超声(HIFU)[Sonablate]联合经尿道前列腺切除术治疗台湾局限性前列腺癌的初步结果。

方法

本研究共纳入 2021 年 4 月至 2022 年 12 月期间 77 例使用 Sonablate HIFU 治疗局限性前列腺癌的患者。在随访期间记录前列腺特异性抗原生化复发、国际勃起功能指数(IIEF)-5 评分、国际前列腺症状评分(IPSS)、生活质量(QoL)评分和术后并发症。

结果

根据 D'Amico 风险分类,总体而言,19.5%的患者为低危,36.4%为中危,44.1%为高危。中位随访时间为 12.09±5.85 个月,低危、中危和高危组的生化无复发生存率分别为 100%(15/15)、96.4%(27/28)和 79.4%(27/34)。4 例(5.2%)患者接受挽救性放疗,均保持生化无复发生存。HIFU 治疗前后 IPSS 和 QoL 评分分别为 10.4 分和 6.8 分(p=0.003)和 3.2 分和 3.0 分(p=0.096)。术前和术后 IIEF 评分(20.6 比 19;p=0.062)在基线时 IIEF 评分>15 且接受神经保留手术(总消融)的患者中无统计学差异。

结论

台湾 Sonablate HIFU 的结果表明,该方法具有良好的短期肿瘤控制效果、优异的勃起功能和控尿能力。HIFU 可以改善 IPSS,且并发症发生率低。

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