新辅助内分泌治疗联合根治性手术及放疗治疗高危、寡转移前列腺癌1例报告
Neoadjuvant endocrine therapy combined with radical surgery and radiotherapy for high-risk and oligometastatic prostate cancer:a case report
李银 1尹皓立 1李俊 1毕颖 1徐石义 1王自勇 1殷俊 1王启林1
作者信息
- 1. 昆明医科大学第三附属医院 泌尿外科,云南 昆明 650118
- 折叠
摘要
采用新辅助恩扎卢胺内分泌治疗联合腹腔镜下根治性前列腺切除术(radical prostatectomy,RP)及局部骨转移病灶放疗治疗高危、寡转移前列腺癌(oligometastatic prostate cancer,OPC)患者1例.患者男,49岁,因"排尿困难1年余"就诊,完善各项检查,前列腺特异性抗原(prostate-specific antigen,PSA)＞100 ng/ml;磁共振成像提示前列腺右侧移行带尖部异常信号结节,前列腺成像报告评分为4分;骨扫描提示右侧肩胛骨下角、T9椎体、胸骨及股骨头转移灶可能.穿刺后病检提示左侧前列腺癌,Gleason评分为4+3=7分.采用恩扎卢胺+亮丙瑞林治疗6个月后,复查PSA为0.014 ng/ml,磁共振成像见前列腺体积缩小,给予患者RP,术后病检为前列腺及肿瘤全取镜下见少许退变的癌细胞,结合病史符合治疗后改变.术后针对骨转移病灶给予放疗同时继续术前内分泌治疗1年余,复查PSA维持在0.01 μg/L,睾酮维持去势水平,未见复发及转移.
Abstract
Neoadjuvant enzalumide endocrine therapy combined with laparoscopic radical prostatectomy and local bone metastases radiotherapy in the treatment of a patient with high-risk and oligometastatic prostate cancer(OPC).A 49-year-old malereceived treatment due to"difficulty in urination for more than 1 year".Prostate-specific antigen(PSA)was more than 100 ng/ml.Magnetic resonance imaging showed abnormal signal nodules in the tip of the right prostatic transitional zone,and prostate imaging reporting and data system score was 4 points.Bone scan indicated possible metastases in the lower corner of the right scapula,T9 vertebra,sternum and femoral head.Pathological finding after prostatic puncture was left side prostate cancer,and Gleason score was 4+3=7.After 6 months of treatment with enzalumide+leuprelin,the patient's PSA rexamination was 0.014 ng/ml.Magnetic resonance imaging showed a reduction in prostate volume.The patient was given RP.The postoperative pathological examination showed prostate and tumor were removed totally,and a few degenerative cancer cells were seen under the microscope,which was consistent with the changes after treatment combined with the medical history.The patient continued to receive radiotherapy for bone metastases after surgery,at the same time,preoperative endocrine therapy was given to patients for more than one year.The patient's PSA reexamination was maintained at 0.01 ng/ml,and testosterone was maintained at castration level.No recurrence or metastasis was observed.
关键词
新辅助内分泌治疗/高危前列腺癌/寡转移前列腺癌/根治性放疗/根治性前列腺切除术Key words
Neoadjuvant hormona therapy/High-risk prostate cancer/Oligometastatic prostate cancer/Radical radiotherapy/Radical prostatectomy引用本文复制引用
基金项目
国家癌症中心攀登基金临床研究项目(NCC201825876)
出版年
2024
NETL
NSTL
万方数据