Ⅰ^125放射性粒子植入联合低剂量调强适形放疗及内分泌治疗在中晚期前列腺癌中的临床疗效评价

Evaluation of efficacy of Ⅰ^125 Brachytherapy combined with low - dose radiotherapy and hormontherapy in Treating intermediate and advanced prostate cancer

目的探讨Ⅰ^125放射性粒子植入（BT）联合低剂量调强适形放疗（IMRT）及间歇内分泌治疗（IHT）在中晚期前列腺癌中的临床疗效。方法回顾性分析选择2009年9月～2014年3月采用BT联合IMRT及IHT治疗中晚期前列腺癌患者16例作为联合治疗组；选择同期单纯采用间歇内分泌治疗患者25例作为对照组。比较两种治疗方法对于治疗中晚期前列腺癌临床疗效的差异。结果16例随访21～62个月，中位随访时间46个月。与对照组相比，联合组PSA、IPSS评分、尿流率及前列腺体积明显下降（P〈0．05），联合治疗5年累计生存率为48．3％，高于对照组的43．2％，差异有统计学意义（P〈0．05）。结论BT植入联合低剂量IMRT及IHT治疗中晚期前列腺癌，可有效提高患者生存率，是中晚期前列腺癌治疗可选择的有效手段之一。

Objectives To investigate the clinical outcome and side effects of low - dose Ⅰ^125 Brachytherapy （BT） combined with intensity modulated radiotherapy（IMRT） and Intermittent Androgen Deprivation（IHT） for the treatment of advanced prostate cancer. Methods The clinical data of 16 cases of prostate carcinoma treated with tri- modality were retrospectively analyzed. All the T3and T4 stage patients received Brachytherapy and IMRT. 25cases in the control group only received intermittent Androgen Deprivation. Results The mean follow -up du- ration was 46 months（ 21 ~ 62months）. Compared with the control group, PSA, IPSS score and prostate volume, uri- nary flow rate decreased significantly（ P 〈 0.05 ）. The5 - year overall survival rates were 48.3% and 43.2% re- spectively（ P 〈 0.05 ）. Conclusions Tri - modality therapy can increase the local toxicity of the surrounding dosage of radiation and decrease the biochemical recurrence in prostate cancer. The rate of tissues is low and patients can gain good tolerability and have quality life.