^(125)I放射性粒子植入联合内分泌治疗中晚期前列腺癌的疗效

Efficacy of permanent ^(125)I prostate brachytherapy combined with endocrine therapy for advanced prostate cancer

目的探讨125I放射性粒子植入联合最大限度阻断雄激素的内分泌治疗中晚期前列腺癌的疗效。方法对5例确诊为前列腺癌患者行125I放射性粒子植入联合内分泌治疗。5例患者均采用全麻下经直肠B超定位下,经会阴125I放射性粒子植入;同时行双侧睾丸切除术,术后给抗雄激素药物行最大限度阻断雄激素的内分泌治疗。根据放射性粒子三维计划系统和质量验证系统行计划设计,逐步植入粒子。观察术后患者病变恢复和并发症发生情况。结果 5例患者手术顺利,手术时间60-120min。术中植入粒子数85-115粒。术后住院时间3-7d。术后排尿畅,无尿急、尿痛。术后随访6-12个月,发现术后2-4个月前列腺特异性抗原(PSA)均降到0.2ng/ml以下,无直肠刺激症状、无血尿和血便;仅有1例术后3个月出现排尿不畅,经过对症治疗后好转。结论经会阴125I放射性粒子植入联合最大限度雄激素阻断的内分泌治疗是治疗中晚期前列腺癌的一种安全有效的方案。

Objective To investigate the efficacy of 12sI brachytherapy combined maximize androgen blockade for advanced prostate cancer. Methods Five patients with advanced prostate cancer were treated by l25I brachytherapy, bilateral orchiectomy, and maximize androgen blockade by drugs, l25 I brachytherapy was performed by the transrectal ultrasound-guided transperineal implantation technique and treatment planning system. The postoperative recovery and complications were observed. Results The surgery in 5 patients was performed smoothly with the operation time of 60-120 min The numbers of implantation were 85 to 115. The postoperative hospital stay was 3 to 7 days without postoperative voiding, urgency or dysuria. The patients were followed up for 6 to 12 months. Serum level of prostate specific antigen reduced to 0. 2 ng/ml or less 2 to 4 months later. There were no rectal irritation, hematuria and bloody stools. One patient had postoperative voiding difficulty 3 months later and symptom was improved after treatment. Conclusion 125I brachytberapy combined maximize androgen blockade is a safe and effective solution for advanced prostate cancer.