^(125)I放射粒子永久性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125I放射粒子永久性植入治疗激素难治性前列腺癌的临床疗效及其价值。方法直肠B超引导下,经会阴穿刺前列腺125I放射粒子植入治疗激素难治性前列腺癌22例,其中3例合并骨转移。结果 22例手术顺利,平均植入125I放射粒子42粒,平均手术时间60分钟,平均住院时间5天,术后随访8-28月,术后3月前列腺缩小,术后短期IPSS评分上升,但3月后开始好转。完全反应16例,部分反应3例,病情稳定3例,PSA无进展生存率100.0%,未发生严重并发症。结论 125I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、患者生活质量高。

Objective To evaluate the clinical significance and curative effect of permanent 125-I prostate brachytherapy in patients with hormone-refractory prostate cancer.Methods A total of 22 patients with hormone-refractory prostate cancer underwent 3-dimensional conformal brachytherapy with transperineal ultrasound-guide 125-I seeds prostate implantation.There were 3 patients with bone metastases.Results The mean number of 125-I seeds implanted was 42.The mean operation time was 60 minutes,and mean hospitalstay was 5 days.All patients were followed up for 8 to 28 months.The prostate volume shrunk from the third month.In the early period after the implantation all the patients complained of some voiding problems and had a noticed increase of international protate symptom score（IPSS）.But the conditions improved gradually from the third month.Sixteening cases had complete reaction;3,partialreaction;3,stablecondition.PSA progression-free survival rate was 100.0%.No severe complication occurred in 22 cases.Conclusion Prostate 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.