摘要
目的回顾性分析^125I粒子植入联合内分泌治疗T3N0M0期前列腺癌的疗效和不良反应。方法临床分期为T3N0M0前列腺癌患者22例，行经直肠超声引导^125I粒子植入联合内分泌治疗。靶区最小周边剂量为140—160Gy，尿道剂量〈400Gy。中位粒子数74颗（26—90颗），中位粒子活度1．55×10^7Bq（1．30×10^7～1．85×10^7）Bq。11例行去势手术，11例行药物去势联合抗雄激素治疗。结果22例患者均顺利完成粒子植入治疗。5年无生化失败生存率为70．6％，总生存率为81．8％。2例于粒子植入术后12个月出现生化失败，1例在术后90个月出现生化失败，重新给予内分泌治疗。粒子植入治疗后1级、2级尿道不良反应发生率分别为54．5％、9．1％，1级和2直肠不良反应发生率分别为22．7％和9．1％，1例出现4级直肠反应。结论放射性^125I粒子植入联合内分泌治疗T3N0M0期前列腺癌创伤小、疗效好，可以考虑应用于不愿接受外放疗的患者。
Objective To retrospectively study the efficacy and side-effect of 1251 seed implantation combined with endocrinal therapy in stage T3NoMo prostate cancer. Methods The study included 22 patients with clinical stage T3 No M0 prostate cancer who were treated with transperineal 125I seed implantation guided by transrectal ultrasound, real time TPS and endocrinal therapy. The minimum peripheral doses （MPD） were 140 - 160 Gy. The median number of seeds was 74（26 -90）. The activity of each seed was 1.55 ×10^7 （ 1.30 ×10^7 - 1.85 ×10^7 ） Bq. 11 patients were treated with orchidectomy, and 11 patients were treated with androgen deprivation therapy. Results All 22 patients completed the seed implantation successfully. The 5-year biochemical progression-free survival was 70. 6% , and 5-year overall survival was 81.8%. 2 patients were found biochemical failure in 12 months after seed implantation, and another 1 patient failed in 90 months. Endocrinal therapy was followed thereafter. After the seed implantation, the urinary complications of grade 1 and 2 were 54. 5 % and 9.1% respectively, and the rectum side-effect of grade 1 and 2 were 22. 7% and 9.1%. 1 patient suffered rectal complication of grade 4. Conclusions Good effect and tolerance are observed in prostate cancer patients of stage T3NoM0 receiving nsI seed implantation plus endocrinal therapy. The treatment can be considered for those who refuse to receive external beam radiotherapy.
出处
《中华放射医学与防护杂志》
CAS
CSCD
北大核心
2012年第5期502-504,共3页
Chinese Journal of Radiological Medicine and Protection
基金
基金项目：首都发展基金（2007-3005）
