摘要
目的探讨经直肠超声引导下^(125)I放射性粒子植入治疗前列腺癌患者术后PSA变化及影响治疗效果的危险因素。方法 2010年1月~2015年12月经直肠超声引导下^(125)I放射性粒子植入治疗的前列腺癌患者70例,年龄52~81岁,平均(67.2±0.7)岁,术前均经病理证实为前列腺癌。术前PSA 5.68~35.43ng/ml,平均(14.42±0.73)ng/ml,临床分期T1c^T2b,Gleason评分4~7分,随访3~60个月,依随访结果分三组:A组:良性反弹组,32例(45.7%),B组:生化复发组,12例(17.1%)。C组:疗效稳定组,26例(37.1%)。结果 A组PSA降至最低值后开始升高时间发生在术后(16.5±1.3)月,且65.6%(21/32)出现于14~27周;B组PSA降至最低值后开始升高时间发生在术后(29.7±2.2)月;C组PSA降至最低值时后长期保持稳定。治疗时患者年龄是良性反弹(A组)的危险因素(P=0.0025,P<0.01)。A组和B组在PSA降至最低值开始升高时间参数中差异具有统计学意义(P<0.01)。结论超声引导下^(125)I放射性粒子植入治疗前列腺癌术后监测血PSA变化有助于临床对治疗效果的评估。
Objective To evaluate the serum Protate-Specific antigen（ PSA） variance and to assess the clinical efficacy after permanent-（125）I prostate brachytherapy in patients with proatate cancer. Methods A total of 70 patients with prostate cancer diagnosed by prostate biopsy,with age of（ 67. 2 ± 0. 7） years,average of PSA（ 14. 42 ± 0. 73） ng/ml,Gleason score from 4 to 7 and clinical stage T1 c - T2 b. All patients underwent permanent-（125）I prostate brachytherapy guided by ultrasound,and were followed up for 3 - 60 months. The patients were divided into the bouble group（ group A）,biological failure group（ group B） and stable efficacy group（ group C）. Results Time to PSA bounce was（ 16. 5 ± 1. 3） months,and 65. 6%（ 21/32） of the bounces occurred between 14 to 27 months after-（125）I prostate brachytherapy. Time to PSA biological failure was（ 29. 7 ± 2. 2） months. Young age was significantly associated to a higher risk of bounce（ P = 0. 0025,P 〈0. 01）. Long delays between brachytherapy and PSA increase were more indicative of BF（ P〈 0. 01）. Conclusion Serum Protate-specific antigen（ PSA） variance after permanent-（125）I prostate brachytherapy is effective for assessing the therapy.
出处
《医学影像学杂志》
2017年第10期1978-1981,共4页
Journal of Medical Imaging
关键词
前列腺癌
^125I放射治疗
PSA
超声引导
Prostate cancer
^125I brachytherapy
Serum Protate-specific antigen
Guided by ultrasound
