光子治疗良性前列腺增生的远期疗效观察（附30例报告）

A clinical study of photon therapy for benign prostate hyperplasia： a report of 30 cases

目的 观察Dolphin-2000型前列腺光子治疗机治疗前列腺增生症的有效性和安全性。方法 用Dolphin-2000型前列腺光子治疗机经直肠近距离照射，治疗中、重度前列腺增生症病人30例，总剂量为726—810cGy，分别于治疗前和后1、6、12个月检测国际前列腺疾患症状评分（IPSS）、生活质量指数（QOL）、前列腺体积重量、膀胱残余尿量、前列腺特异性抗原（PSA）、最大尿流率（Qmax）以及血常规、尿常规、肝、肾功能及其他不良反应等情况。结果治疗前后IPSS、QOL、前列腺体积、Qmax、残余尿均发生明显的变化（P〈0．05）。治疗后1个月，显效18例，好转9例，较差3例；治疗后6个月，显效20例，好转8例，较差2例；治疗后12个月，显效22例，好转7例，较差1例。治疗后复查血常规、尿常规、肝肾功能、PSA均无明显异常。结论 Dolphin-2000型前列腺光子治疗机治疗中、重度前列腺增生症安全有效，无创伤，方便经济，不需住院，尤其适用于合并有其它系统疾病不能耐受手术的高危高龄前列腺增生病人。

Objective To investigate the clinical efficacy and safety of photon therapy for benign prostate hyperplasia （BPH）. Methods 30 patients with severe BPH were enrolled in this study, age from 59 to 87 years （ mean ： 71.6 ±6.8years）. They received brachytherapy of prostate photon treatment system irradiation , with the active area of the applicator located in rectum , at the total dosage of 726 -810 cGy. After treatment,they were followed up in the 1 st, 6 th, 12 th month respectively. Before and after the treatment, the follow up studies included international prostate symptom score （IPSS） , quality of lfie （QOL）, volume of prostate gland, maximum flow rate （Qmax） and residual urine, blood cells ,urine cells and protein ,function of liver and kidney. Results There was significant improvement in IPSS, QOL, volume of prostate gland ,Qmax and residual urine after treatment（P 〈0.05 ）. In The first month after treatment, 18 cases were remarkably improved ,9 cases were slightly improved and 3 cases were ineffective. In the 6th month after treatmeat, 20 eases were remarkably improved,8 cases were slightly improved and 2 cases were ineffective. In the 12th month after treatmeat, 22 cases were remarkably impreved,7 cases were slightly improved and 1 case was ineffective. Conclusion The prostate photon treatment system can be used as a safe, effective, minimally invasive, convenient and economical therapy for severe BPH, especially applicable for elder and weak patients with BPH. Further study is needed to support the conclusions.