^(125)I放射粒子植入治疗激素难治性前列腺癌

Permanent ^(125)I prostate brachytherapy for hormone-refractory prostate cancer

目的 探讨12 5I放射粒子植入治疗激素难治性前列腺癌的临床价值。 方法 直肠B超引导下 ,经会阴穿刺前列腺12 5I放射粒子植入治疗激素难治性前列腺癌 15例 ,其中 5例合并骨转移者同时行转移灶外放疗。 结果 15例手术顺利 ,平均植入12 5I放射粒子 5 6粒 ,平均手术时间 70min ,平均住院时间 5d。术后随访 5～ 2 8个月 ,平均 11个月 ,完全反应 5例 ,部分反应 4例 ,病情稳定 3例 ,病情恶化 3例 ,PSA无进展生存率 80 % ( 12 /15 ) ,未发生严重并发症。 结论 12 5I放射粒子植入治疗激素难治性前列腺癌安全、微创、并发症发生率低 ,疗效肯定。

Objective To evaluate the clinical significance of permanent 125 I prostate brachytherapy in patients with hormone refractory prostate cancer. Methods A total of 15 patients with hormone refractory prostate cancer underwent 3 dimensional conformal brachytherapy with transperineal ultrasound guide 125 I seeds prostate implantation. Of them 5 patients with bone metastases were treated by EBRT one month later. Results The mean number of 125 I seeds implanted was 56.The mean operation time was 70 min,and mean hospital stay was 5 d.All patients were followed up for 5 to 28 months with a mean of 11 months.5 cases had complete reaction;4, partial reaction;3,stable condition;and 3 developed progressive disease. PSA progression free survival rate was 80% (12/15).No severe complication occurred in all cases. Conclusions Brachytherapy with 125 I seeds implantation guided by transrectal ultrasound is a safe,minimally invasive and effective treatment with low morbidity for hormone refractory prostate cancer patients.