^(125)I粒子永久性植入治疗前列腺癌42例临床分析

Permanent transrectal ^(125)I seeds implantation for analysis of 42 cases prostate cancer

目的探讨125I放射粒子植入联合手术去势治疗局部晚期前列腺癌的临床效果。方法晚期前列腺癌患者82例,治疗组42例,采用经直肠B超引导下经直肠植入125I放射粒子并同时行双侧睾丸切除治疗。对照组40例施行双侧睾丸切除术。82例患者术后同时服用比卡鲁胺内分泌化疗药物。结果所有患者手术过程顺利,术后随访24～48个月,中位随访时间36.5个月。治疗组平均植入粒子(38±15)粒。无因经直肠穿刺引起的严重并发症。1例术后16个月发生骨转移,有2例在术后平均18.6个月出现PSA生化复发,累计PSA无进展患者生存率为92.8%。对照组中1例于术后23个月死亡,3例在术后14个月发生骨转移,有5例在术后平均15.8个月出现PSA生化复发,累计PSA无进展患者生存率为77.5%。结论对于局部晚期前列腺癌。

Objective To study the clinical efficacy of 125I brachytherapy combined with surgical castration for treating local advanced prostate cancer.Methods A total of 82 prostate cancer patients were recruited.In treatment group,42 patients with advanced prostate cancer underwent 125I transrectal brachytherapy guided by rectal ultrasound B and orchiectomy at the same time.40 cases of control group were performed orchiectomy.Hormonal therapy with Bicalutamide was performed in all patients after operation.Results All procedures were completed smoothly.Follow up ranged from 24～48months,with the median of 36.5 months.In treatment group,the average were（38±15） particles.No severe complication appeared through per-rectum 125I seeds long term implantation.One case was diagnosed with bone metastasis 16 months after the surgery.2 cases had biochemical progression an average of 18.6 months post-operation.Cumulative PSA progression free survival rate was 92.8%.In control group,1 case died in 23 months post-operation.3 case was diagnosed with bone metastasis 14 months after the surgery.5 cases had biochemical progression an average of 15.8 months post-operation.Cumulative PSA progression free survival rate was77.5%.Conclusion The 125I transrectal brachytherapy combined with surgical castration is an effective and safe treatment for locally advanced prostate cancer.