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【medical-news】High-Intensity Focused Ultrasound Effective Against High-Risk Prostate Cancer

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High-Intensity Focused Ultrasound Effective Against High-Risk Prostate Cancer
By Will Boggs, MD

NEW YORK (Reuters Health) Jan 15 - High-intensity focused ultrasound (HIFU) safely provides favorable short-term outcomes in men with high-risk prostate cancer, according to a report in the December 2006 issue of BJU International.

"HIFU is based on a focused form of energy providing higher safety and precision than divergent energies (cryotherapy, radiotherapy)," Dr. Vincenzo Ficarra from the University of Verona, Italy told Reuters Health. "In patients with a high risk for progression or with locally advanced disease, this treatment might represent a valid alternative to radiotherapy."

Dr. Ficarra and colleagues investigated the short-term outcome of HIFU treatment in 30 patients with high-risk prostate cancer who had all previously undergone transurethral resection of the prostate. HIFU was administered under general anesthesia, and they received concomitant hormonal therapy.

No complications were reported during HIFU, which required a median overall duration of 140 minutes to produce a median 750 lesions, the authors report. The mean hospital stay was 2.2 days.

Symptomatic lower urinary tract infections were reported in 5 patients during the first year, the results indicate, and 3 patients experienced urethral stenoses that were treated by cold-knife incision and subsequent urethral calibration.

Three months after HIFU, 25 patients had complete urinary continence, the researchers note, and all but 2 patients (78 and 79 years old) were continent after 12 months.

Six months after HIFU, the median prostate volume was significantly lower than the baseline value, the report indicates. Sextant prostate biopsy was positive in 7 patients (23%), including 4 with one positive core and 3 with two positive cores.

None of the patients had PSA values above 1.0 ng/mL at 1 year, the investigators say, and only 3 patients (all of whom had two positive cores at the 6-month sextant prostate biopsy) had PSA values above 0.3 ng/mL.

"In case of biochemical or clinical persistence or recurrence, it is possible to repeat HIFU local treatment," Dr. Ficarra said. "In this case, it is necessary to inform the patient that perioperative complication rates could be higher than those at the first treatment."

"I would like to emphasize the low invasiveness of this kind of treatment, the short in-hospital stay, and the possibility to further improve the software of the device," Dr. Ficarra said.

"Future studies will evaluate long-term oncological results, still lacking in current literature," Dr. Ficarra added. "As previous studies, they will be based on the association of HIFU with LHRH analogues."

BJU International 2006;98:1193-1198.

http://www.medscape.com/viewarticle/550786

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2007-01-16 13:08 浏览 : 656 回复 : 2

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2007-01-16 13:12

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High-Intensity Focused Ultrasound Effective Against High-Risk Prostate Cancer
By Will Boggs, MD
高功率聚焦超声有效对抗高危前列腺癌
作者：Will Boggs, MD
NEW YORK (Reuters Health) Jan 15 - High-intensity focused ultrasound (HIFU) safely provides favorable short-term outcomes in men with high-risk prostate cancer, according to a report in the December 2006 issue of BJU International.
纽约（路透社 Health）1月15日据2006年12月的BJU International刊登的一篇报道，高功率聚焦超声 (HIFU) 对高危前列腺癌男性患者能够发挥安全的短期疗效。
"HIFU is based on a focused form of energy providing higher safety and precision than divergent energies (cryotherapy, radiotherapy)," Dr. Vincenzo Ficarra from the University of Verona, Italy told Reuters Health. "In patients with a high risk for progression or with locally advanced disease, this treatment might represent a valid alternative to radiotherapy."
“HIFU基于一种聚焦的能量，相对其它产能的治疗方法（冷冻疗法，放射疗法）安全性和精密度都要高。”意大利Verona大学的Dr. Vincenzo Ficarra说，“当患者的病情恶化的风险很高，或患有局部严重的疾病时，这种疗法可作为放射疗法的有效补充。”
Dr. Ficarra and colleagues investigated the short-term outcome of HIFU treatment in 30 patients with high-risk prostate cancer who had all previously undergone transurethral resection of the prostate. HIFU was administered under general anesthesia, and they received concomitant hormonal therapy.
Dr. Ficarra及其同事研究了HIFU对30名高危前列腺癌患者的短期疗效。这些患者均接受过经尿道切除前列腺手术。全身麻醉后对他们进行高功率聚焦超声疗法，伴随激素治疗。
No complications were reported during HIFU, which required a median overall duration of 140 minutes to produce a median 750 lesions, the authors report. The mean hospital stay was 2.2 days.
在高功率聚焦超声治疗过程中无并发症，该过程平均耗时140分钟，平均对患处造成750次伤害，作者报道。患者的平均住院时间为2.2天。
Symptomatic lower urinary tract infections were reported in 5 patients during the first year, the results indicate, and 3 patients experienced urethral stenoses that were treated by cold-knife incision and subsequent urethral calibration.
结果显示，第一年5名患者有明显的下尿路感染，3名患者尿道狭窄，通过冷刀切割手术治疗并在术后测量尿道口径。
Three months after HIFU, 25 patients had complete urinary continence, the researchers note, and all but 2 patients (78 and 79 years old) were continent after 12 months.
研究者记录，高功率聚焦超声治疗后三个月，25位患者能够完全控制排尿，所有患者中只有2位患者（分别为78岁，79岁）在12个月后能控制排尿。
Six months after HIFU, the median prostate volume was significantly lower than the baseline value, the report indicates. Sextant prostate biopsy was positive in 7 patients (23%), including 4 with one positive core and 3 with two positive cores.
研究表明，经高功率聚焦超声治疗后六个月患者的平均前列腺体积明显低于基线值。7位患者（23％）的六分之一前列腺生检呈阳性，其中4位有一个阳性核心，3位有两个阳性核心。
None of the patients had PSA values above 1.0 ng/mL at 1 year, the investigators say, and only 3 patients (all of whom had two positive cores at the 6-month sextant prostate biopsy) had PSA values above 0.3 ng/mL.
无一名患者在一年内前列腺特异性抗原（PSA）值在1.0 ng/mL以上，其中只有3名患者（均在六个月前列腺生检中有两个阳性核心）的PSA值在0.3 ng/mL以上。
"In case of biochemical or clinical persistence or recurrence, it is possible to repeat HIFU local treatment," Dr. Ficarra said. "In this case, it is necessary to inform the patient that perioperative complication rates could be higher than those at the first treatment."
“如果在生化研究或临床治疗中癌症有残留或复发现象，可以重复使用高功率聚焦超声局部治疗方法，” Dr. Ficarra说，“在这种情况下，有必要告知病人手术中的并发症发生率要高于第一次治疗时。”
"I would like to emphasize the low invasiveness of this kind of treatment, the short in-hospital stay, and the possibility to further improve the software of the device," Dr. Ficarra said.
“我要强调的是这种治疗手段侵袭力低，患者住院时间短，而且有可能进一步升级设备的软件程序。” Dr. Ficarra说。
"Future studies will evaluate long-term oncological results, still lacking in current literature," Dr. Ficarra added. "As previous studies, they will be based on the association of HIFU with LHRH analogues."
“进一步的研究将是评价长期肿瘤学的治疗结果，目前缺乏相应报道，” Dr. Ficarra补充，“和前期研究一样，将继续通过高功率聚焦超声和促黄体激素－释放激素（LHRH）的协同治疗。”
BJU International 2006;98:1193-1198.

高功率聚焦超声有效对抗高危前列腺癌
作者：Will Boggs, MD
纽约（路透社 Health）1月15日据2006年12月的BJU International刊登的一篇报道，高功率聚焦超声 (HIFU) 对高危前列腺癌男性患者能够发挥安全的短期疗效。
“HIFU基于一种聚焦的能量，相对其它产能的治疗方法（冷冻疗法，放射疗法）安全性和精密度都要高。”意大利Verona大学的Dr. Vincenzo Ficarra说，“当患者的病情恶化的风险很高，或患有局部严重的疾病时，这种疗法可作为放射疗法的有效补充。”
Dr. Ficarra及其同事研究了HIFU对30名高危前列腺癌患者的短期疗效。这些患者均接受过经尿道切除前列腺手术。全身麻醉后对他们进行高功率聚焦超声疗法，伴随激素治疗。
在高功率聚焦超声治疗过程中无并发症，该过程平均耗时140分钟，平均对患处造成750次伤害，作者报道。患者的平均住院时间为2.2天。
结果显示，第一年5名患者有明显的下尿路感染，3名患者尿道狭窄，通过冷刀切割手术治疗并在术后测量尿道口径。
研究者记录，高功率聚焦超声治疗后三个月，25位患者能够完全控制排尿，所有患者中只有2位患者（分别为78岁，79岁）在12个月后能控制排尿。
研究表明，经高功率聚焦超声治疗后六个月患者的平均前列腺体积明显低于基线值。7位患者（23％）的六分之一前列腺生检呈阳性，其中4位有一个阳性核心，3位有两个阳性核心。
无一名患者在一年内前列腺特异性抗原（PSA）值在1.0 ng/mL以上，其中只有3名患者（均在六个月前列腺生检中有两个阳性核心）的PSA值在0.3 ng/mL以上。
“如果在生化研究或临床治疗中癌症有残留或复发现象，可以重复使用高功率聚焦超声局部治疗方法，” Dr. Ficarra说，“在这种情况下，有必要告知病人手术中的并发症发生率要高于第一次治疗时。”
“我要强调的是这种治疗手段侵袭力低，患者住院时间短，而且有可能进一步升级设备的软件程序。” Dr. Ficarra说。
“进一步的研究将是评价长期肿瘤学的治疗结果，目前缺乏相应报道，” Dr. Ficarra补充，“和前期研究一样，将继续通过高功率聚焦超声和促黄体激素－释放激素（LHRH）的协同治疗。”
BJU International 2006;98:1193-1198.

2007-01-17 13:26

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