摘要
目的探讨经直肠超声引导下经会阴125I粒子永久植入治疗前列腺癌的疗效和并发症。方法本组前列腺癌患者5例。年龄61￣83岁,平均70.4岁。临床分期T2bN0M0者2例,T3aN0M0者3例。Gleason评分6分者2例,7分者1例,8分者2例。术前前列腺特异性抗原(PSA)4.5￣17.5ng/ml。T3a期患者植入治疗前先行内分泌治疗。术前制定治疗计划,经直肠超声引导下经会阴125I粒子永久植入操作。术后观察PSA水平变化,连续3次PSA升高即为生化复发,观察术后尿路和直肠并发症发生情况。结果5例患者均术后恢复顺利。术后随访18个月,PSA均明显下降,PSA为0.1ng/ml者3例,0.01ng/ml者1例,0.04ng/m1者1例。5例患者术后均出现不同程度的尿路刺激症状,但6个月后逐渐好转。4例术后出现排便次数增多,术后3个月均好转。未发现尿失禁、直肠溃疡等并发症。结论经直肠超声引导下经会阴125I粒子永久植入治疗前列腺癌的疗效确切,创伤较小。
Objective To evaluate the efficacy and complications of permanent interstitial brachytherapy in the treatment of prostate cancer. Methods Five patients （mean age, 70.4 years; range, 61-83 years） with clinically stage T2b to T3a prostate cancer were treated with iodine- 125 brachytherapy using the transrectal ultrasound guided transperineal implantation technique and treatment planning system. Gleason scores were 6, 8, 6, 7, 8. Three patients with T3a prostate cancer were treated with brachytherapy combined with hormonal therapy. The follow-up period was 18 months. Biochemical failure was defined as consecutive elevations of PSA level for three times during follow-up period. Results After implantation, the PSA levels of the 5 patients were decreased significantly and were all less than 0.2 ng/ml at 18th month. In the early period after the implantation all the patients experienced acute irritative or obstructive urinary symptoms. But the conditions improved gradually from the sixth month. Diarrhea was found in 4 cases and disappeared gradually from the third month. No serious complications such as incontinence and rectal ulcer were found in this group. Conclusion Permanent interstitial brachytherapy has bettter efficacy and fewer complications in the treatment of clinically localized prostate cancer.
出处
《中国男科学杂志》
CAS
CSCD
2006年第2期29-32,共4页
Chinese Journal of Andrology
关键词
前列腺肿瘤
放射疗法
碘
prostatic neoplasms/radiotherapy
iodine
