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中华腔镜泌尿外科杂志(电子版)

中华腔镜泌尿外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (06) : 374 -377. doi: 10.3877/cma.j.issn.1674-3253.2019.06.004

所属专题： 经典病例； 经典病例； 文献；

病例研究·（最强挑战赛优秀病例）

一例寡转移前列腺癌患者基于循证医学的多学科综合诊治报告
王进有1, 谢栋栋1, 毕良宽1, 王毅1, 于德新1,†()   
  1. 1. 230601　合肥，安徽医科大学第二附属医院泌尿外科
  • 收稿日期:2019-03-01 出版日期:2019-12-01
  • 通信作者: 于德新
  • 基金资助:
    安徽省自然科学基金(1608085QH173); 安徽医科大学第二附属医院科技新星培优计划项目(2018KA01)

The multidisciplinary management of oligometastatic prostate cancer: a case report and review of literatures

Jinyou Wang1, Dongdong Xie1, Liangkuan Bi1, Yi Wang1, Dexin Yu1,†()   

  1. 1. Department of Urology, the Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China
  • Received:2019-03-01 Published:2019-12-01
  • Corresponding author: Dexin Yu
  • About author:
    Corresponding author: Yu Dexin, Email:
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引用本文：

王进有, 谢栋栋, 毕良宽, 王毅, 于德新. 一例寡转移前列腺癌患者基于循证医学的多学科综合诊治报告[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2019, 13(06): 374-377.

Jinyou Wang, Dongdong Xie, Liangkuan Bi, Yi Wang, Dexin Yu. The multidisciplinary management of oligometastatic prostate cancer: a case report and review of literatures[J/OL]. Chinese Journal of Endourology(Electronic Edition), 2019, 13(06): 374-377.

目的

探讨基于循证医学寡转移前列腺癌的综合治疗模式，以期延长患者生存时间。

方法

回顾性分析一例在我院行多学科协作诊治的寡转移前列腺癌患者临床资料，复习相关文献并予以讨论。

结果

患者初诊PSA为60 μg/L，盆腔MRI考虑前列腺癌，双侧精囊受侵，左侧输尿管口受侵，全身骨扫描可见四处骨转移，前列腺穿刺活检诊断为前列腺腺泡癌，Gleason评分4+5=9分。患者自2016年5月起以雄激素剥夺治疗为基础，先后序贯行新辅助化疗、减瘤性根治性前列腺切除术、立体定向放疗、阿比特龙+泼尼松治疗及再次多西他赛化疗，随访至2018年12月，患者无明显疼痛不适，但PSA升高，出现新发骨转移灶。

结论

循证医学给此类患者治疗选择带来更多的依据，多学科治疗模式可延长寡转移前列腺癌患者生存时间，改善生活质量。

关键词: 寡转移, 前列腺癌, 多学科, 综合治疗
Objective

To discussion the application of multidisciplinary comprehensive diagnosis and treatment of oligometastatic prostate cancer.

Methods

The clinical data of an oligometastatic prostate cancer patient treated with multidisciplinary comprehensive mode was analyzed retrospectively, and related literatures were reviewed.

Results

PSA of the patient was 60 μg/L. The pelvic MRI considered to be prostate cancer with bilateral seminal vesicle and left ureteral orifice invasion, diagnosis was confirmed by prostate biopsy and the Gleason score was 4+5, ECT scan found four bone metastases. The patient had been treated with androgen deprivation therapy since May 2016. He had undergone sequential neoadjuvant chemotherapy, cytoreductive radical prostatectomy, stereotactic radiotherapy, abiraterone + prednisone and Docetaxel chemotherapy. After follow-up until December 2018, the patient had no significant pain and discomfort, but the PSA increased.

Conclusion

Multidisciplinary treatment can prolong survival and improve quality of life in patients with oligometastatic prostate cancer.

Key words: Oligometastasis, Prostate cancer, Multidisciplinary, Synthetic therapy
图1 患者初诊时前列腺MRI及全身骨扫描检查
图2 寡转移前列腺癌患者综合治疗过程中tPSA变化图
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