Terai A, Arai Y, Onishi H, Oishi K, Takeuchi H, Yoshida O
Department of Urology, Faculty of Medicine, Kyoto University, Japan.
Int J Urol. 1995 Mar;2(1):24-8. doi: 10.1111/j.1442-2042.1995.tb00615.x.
Since September 1992, 63 patients with symptomatic benign prostatic hyperplasia (BPH) have been treated with transurethral microwave thermotherapy (TUMT) using the Prostatron device. The International Prostate Symptom Score (I-PSS) and quality of life (QOL) score were used to evaluate subjective symptoms. The mean I-PSS (total, irritative and obstructive scores) and QOL scores had decreased by 40, 38, 45 and 40%, respectively, at 12 months (p < 0.0001). While the mean peak flow rate had increased by 72% (p < 0.001). The clinical efficacy at 12 months was 42%, using a modification of the response criteria proposed at the 2nd International Consultation on Benign Prostatic Hyperplasia. There were no significant differences in the baseline and treatment parameters between those who responded favorably to TUMT and those who did not. The total thermal dose delivered to the prostate did not predict clinical response. However, there was a positive correlation between I-PSS or QOL at baseline and % reduction at 3, 6 and 12 months, and a negative correlation between peak flow rate at baseline and % increase at 3 and 6 months. There were no major complications associated with TUMT during the follow-up period. In summary, our 1-year clinical results are compatible with previous reports, suggesting that TUMT is a safe, effective and lasting non-surgical treatment for BPH. However, evaluation of efficacy should be based on uniform criteria to facilitate comparisons of different clinical trials. The most suitable patient profiles for TUMT could not be identified by retrospective analysis.
自1992年9月以来，63例有症状的良性前列腺增生（BPH）患者使用Prostatron设备接受了经尿道微波热疗（TUMT）。采用国际前列腺症状评分（I-PSS）和生活质量（QOL）评分来评估主观症状。在12个月时，平均I-PSS（总分、刺激性症状评分和梗阻性症状评分）和QOL评分分别下降了40%、38%、45%和40%（p<0.0001）。而平均最大尿流率增加了72%（p<0.001）。根据第二届良性前列腺增生国际咨询会议提出的反应标准进行修改后，12个月时的临床有效率为42%。对TUMT反应良好者和反应不佳者在基线和治疗参数方面无显著差异。输送到前列腺的总热剂量并不能预测临床反应。然而，基线时的I-PSS或QOL与3个月、6个月和12个月时的降低百分比呈正相关，基线时的最大尿流率与3个月和6个月时的增加百分比呈负相关。随访期间未发生与TUMT相关的重大并发症。总之，我们的1年临床结果与先前的报告一致，表明TUMT是一种安全、有效且持久的BPH非手术治疗方法。然而，疗效评估应基于统一标准，以方便不同临床试验之间的比较。通过回顾性分析无法确定最适合TUMT的患者特征。
