^(125)I放射性粒子植入治疗C期激素难治性前列腺癌

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

目的探讨^(125)Ⅰ放射性粒子植入治疗C期激素难治性前列腺癌的临床疗效。方法本组11例,均通过前列腺穿刺活检确诊为前列腺癌,G1eason评分6～9分,经内分泌治疗后确认进展为激素难治性前列腺癌时平均PSA为1 0.91 ng/ml,临床分期均为C期,行直肠B超引导下,经会阴穿刺植入放射性^(125)Ⅰ粒子治疗。结果全组患者手术顺利,手术时间30～70min,平均植入粒子49粒,均于术后3～6d出院。术后随访3～71个月,平均3 1个月。完全有效3例,部分有效1例,病情稳定3例,无效3例,失访1例,PSA无进展生存率70%(7/1 0)。无效患者3例中,2例PSA无进展生存期达2年以上。所有患者术后均未出现严重并发症。结论 ^(125)Ⅰ放射性粒子植入治疗C期激素难治性前列腺癌安全、有效。

Objective To evaluate the clinical efficacity of permanent 125I prostate brachytherapy in patients with stage C hormone refractory prostate cancer. Methods A total of 11 patients with prostate cancer was diagnosed by prostate biopsy, Gleason score of them was 6-9, average PSA was 10.91ng/ml at the progression to hormone refractory prostate cancer, and clinical staging was C stage. All patients underwent 3-dimensional conformal brachytherapy with transperineal ultrasound-guide 125I seeds prostate implantation. Results None of the patients had any adverse events during the operation processes. The operation time was from 30 to 70 mins and hospital staying time was from 3 to 6 days. The mean number of implanted 125I seeds was 49. All patients were followed up for 3 to 71 months with a mean of 31 months. Of them, 3 cases had complete reaction, 1 partial reaction, 3 stable condition and 3 developed progres- sive disease（PD）, one patient lost during following-up. The survival rate of PSA progression free was 70 % （7/10）. For other 3 PD patients, 2 patients＇ PSA progression free survival time was longer than 2 years. No severe complication occurred in all cases. Conclusion Brachytherapy with 125I seeds implantation is a safe and effective treatment for patients with stage C hormone refractory prostate cancer.