单纯^125I放射性粒子植入治疗早期前列腺癌的临床分析

Clinical analysis of permanent ^125I prostate brachytherapy monotherapy for early prostate cancer （ report of 18 cases）

目的探讨单纯^125I放射性粒子植入治疗早期前列腺癌的临床疗效。方法2007年1月至2011年7月前列腺癌患者18例，年龄60～81岁，平均74岁。术前PSA0．38—8．73μg／L，平均5．09μg／L。均经前列腺穿刺病理诊断为前列腺癌，Gleason评分5—6分，临床分期T1c-T24。采用直肠B超引导下经会阴植入^125I粒子治疗。结果本组手术顺利，手术时间37～52min，平均植入粒子54粒，术后住院时间3—4d。随访时间3～57个月，平均15个月，1例失访。随访17例血PSA无进展生存率为100％（17／17），7例随访超过18个月，血PSA水平长期低于0．20仙g／L，其中3例波动于0—0．08μg／L，3例波动于0．02—0．12μg／L，1例波动于0．12～0．20μg／L。17例均未出现严重并发症。结论单纯^125I放射性粒子植入治疗早期前列腺癌安全、有效。

Objective To evaluate the clinical efficacy of permanent ^125I prostate brachytherapy monotherapy in patients with early prostate cancer. Methods A total of 18 patients with prostate cancer was diagnosed by prostate biopsy, with Gleason score 5 - 6, average PSA 5.09 ng/ml （range, 0.38 - 8.73） , and clinical stage Tlo - T2. All patients underwent 3-dimensional conformal brachytherapy with transperineal ultrasound-guide ^125I seeds prostate implantation. Results None of the patients had any ad- verse events during the operation processes. The operation time was from 37 to 52 minutes and postoperative hospitalization time was from 3 to 4 days. The mean number of implanted 125I seeds was 54. All patients were followed up for 3 to 57 months with a mean of 15 months, while one patient was lost during followingup. The survival rate of PSA progression free was 100% （17/17）. The PSA was under 0.2 ng/ml for a long time in the 7 cases who had been followed-up for more than 18 months. The PSA did not show any rising trend in all 17 cases. No severe complications occurred in all cases. Conclusions Brachytherapy monotherapy with ^125I seeds implantation is safe and effective for patients with early prostate cancer.