^(125)I放射性粒子植入治疗前列腺癌

Ultrasound-guided Radioactive ^(125)I Seed Implantation Treatment of Prostatic Cancer

目的:探讨超声引导^(125)I放射性粒子植入治疗前列腺癌的可行性和效果。方法:15例前列腺癌患者均经会阴超声引导放射性^(125)I粒子植入治疗。每颗粒子活度为0.35~0.50 m Ci,肿瘤匹配周边剂量(MPD)130~150Gy,最多植入粒子82颗,最少植入粒子29颗,平均植入50颗。结果:15例患者术后经X线证实植入部位精确。最长随访18个月,最短随访时间3个月,中位随访时间16个月。治疗前后血清前列腺特异抗原(PSA)均值分别为51.6 ng/m L和0.14 ng/m L,影像学检查前列腺体积均值分别为35.5 cm^3和22.5 cm^3,统计学处理差异显著(P<0.05),随访16个月时,15例均存活。术后3个月患者出现Ⅰ级尿道症状11例,Ⅱ级尿道症状4例,直肠刺激症状5例,经对症治疗,在6个月后症状缓解。结论:^(125)I放射性粒子植入治疗前列腺癌安全、微创、不良反应较轻。

Objective To investigate the feasible and effects of transperineal ^125I seed implantation on,treating patients with prostatic cancer. Methods From June 2007 to December 2008, 15 patients with prostatic cancer were treated with ^125I seed implantation brachytherapy. The matched peripheral doses were 130-150 Gy, the strength of the ^125I sources ranged from O. 35 to 0.50 mCi, up to 82 seeds, at least 29 seeds, an average of 50 seeds. Results The sites of seeds in 15 patients were confirmed accurate by postoperative X ray after implantation. All the patients were followed up for 3 - 18 months, with a median follow-up time of 16 months. The mean values of serum prostate-specific antigen （PSA） were 51.6 ng/mL and 0.14 ng/mL before and after treatment, respectively. The mean volume of prostate examed by imaging were 35.5 cm^3 and 22.5 cm^3 before and after treatment, respectively, which had significantly differences（ P〈0.05 ）.Fifteen patients were still survived after following up for 16 months. The adverse reactions including urinary degree Ⅰ symptoms, degree Ⅱ symptoms and rectal irritation were observed in 11 cases, 4 cases and 5 cases at 3 months postoperation, respectively. All the adverse reactions were alleviated after symptomatic treatment of 6 months. Conclusion Transperineal 125I seed implantation is a safety and m. inimally invasive method for prostate cancer treatment with its slight adverse reactions.