在经尿道微波热疗中增加热剂量并不能提高治疗效果。

Increasing the thermal dose in transurethral microwave thermotherapy produces no improvement in therapeutic efficacy.

作者信息

Terai A, Shichiri Y, Onishi H, Arai Y, Oishi K, Takeuchi H, Yoshida O

机构信息

Department of Urology, Faculty of Medicine, Kyoto University, Japan.

出版信息

Int J Urol. 1995 Jul;2(3):186-90. doi: 10.1111/j.1442-2042.1995.tb00451.x.

DOI:10.1111/j.1442-2042.1995.tb00451.x

PMID:8536136

Abstract

BACKGROUND

Transurethral microwave thermotherapy (TUMT) is a minimally invasive treatment for benign prostatic hyperplasia (BPH). It has been reported that increased thermal dose and higher intraprostatic temperatures resulted in improved clinical response. Recently we treated BPH patients with the prostatron device using a new version of software (Prostasoft 2.5), which was intended to increase thermal delivery by allowing maximum power up to 70W. The safety and clinical results were compared between the patients treated with Prostasoft 2.5 and those treated with the currently available software (Prostasoft 2; maximum power up to 50W).

METHODS

A total of 105 patients were treated successively with two treatment protocols. Sixty-three patients were treated with Prostasoft 2 between September 1992 and July 1993, while 42 were treated with Prostasoft 2.5 between August 1993 and April 1994. Therefore, this investigation was a retrospective nonrandomized study. There was no significant difference in the baseline patient characteristics between the two groups.

RESULTS

Total thermal dose delivered to the prostate was significantly higher in the Prostasoft 2.5 group than that in the Prostasoft 2 group (137 kJ versus 116 kJ, P < 0.05). No serious complications were encountered in either group. Six months after TUMT, in both the Prostasoft 2.5 and Prostasoft 2 groups there was an improvement in patient condition as measured by the mean I-PSS, QOL, and peak flow rate values, as well as the overall therapeutic efficacy. The two groups differed in the amount of posttreatment improvement from between 8% and 22%, but this difference was not statistically significant.

CONCLUSIONS

Our study suggests that higher thermal dose attained by Prostasoft 2.5 does not necessarily result in more pronounced clinical improvement, although clinical response to TUMT has often been reported to be dependent upon thermal dose.

摘要

背景

经尿道微波热疗（TUMT）是一种治疗良性前列腺增生（BPH）的微创疗法。据报道，热剂量增加及前列腺内温度升高可改善临床疗效。最近，我们使用新版本软件（Prostasoft 2.5）通过前列腺治疗仪治疗BPH患者，该软件旨在通过允许最大功率达70W来增加热量传递。比较了使用Prostasoft 2.5治疗的患者与使用现有软件（Prostasoft 2；最大功率达50W）治疗的患者的安全性及临床结果。

方法

总共105例患者先后接受了两种治疗方案。1992年9月至1993年7月期间，63例患者使用Prostasoft 2进行治疗，而1993年8月至1994年4月期间，42例患者使用Prostasoft 2.5进行治疗。因此，本研究为回顾性非随机研究。两组患者的基线特征无显著差异。

结果

Prostasoft 2.5组传递至前列腺的总热剂量显著高于Prostasoft 2组（137千焦对116千焦，P<0.05）。两组均未出现严重并发症。TUMT治疗6个月后，Prostasoft 2.5组和Prostasoft 2组患者的病情均有改善，通过平均国际前列腺症状评分（I-PSS）、生活质量（QOL）、峰值尿流率值以及总体治疗效果来衡量。两组治疗后改善程度在8%至22%之间有所不同，但这种差异无统计学意义。