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前列腺癌近距离治疗疗效

严维刚,  李汉忠,  周毅,  陈健,  李宏军,  张福泉

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文章导航 > 协和医学杂志  > 2011 >  2(1): 24-27
严维刚, 李汉忠, 周毅, 陈健, 李宏军, 张福泉. 前列腺癌近距离治疗疗效[J]. 协和医学杂志, 2011, 2(1): 24-27. doi: 10.3969/j.issn.1674-9081.2011.01.005
引用本文: 严维刚, 李汉忠, 周毅, 陈健, 李宏军, 张福泉. 前列腺癌近距离治疗疗效[J]. 协和医学杂志, 2011, 2(1): 24-27. doi: 10.3969/j.issn.1674-9081.2011.01.005
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Wei-gang YAN, Han-zhong LI, Yi ZHOU, Jian CHEN, Hong-jun LI, Fu-quan ZHANG. Outcomes of Prostate Cancer Patients after Brachytherapy[J]. Medical Journal of Peking Union Medical College Hospital, 2011, 2(1): 24-27. doi: 10.3969/j.issn.1674-9081.2011.01.005
Citation: Wei-gang YAN, Han-zhong LI, Yi ZHOU, Jian CHEN, Hong-jun LI, Fu-quan ZHANG. Outcomes of Prostate Cancer Patients after Brachytherapy[J]. Medical Journal of Peking Union Medical College Hospital, 2011, 2(1): 24-27. doi: 10.3969/j.issn.1674-9081.2011.01.005
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前列腺癌近距离治疗疗效

doi: 10.3969/j.issn.1674-9081.2011.01.005
  • 1.

    中国医学科学院 北京协和医学院 北京协和医院泌尿外科, 北京 100730

  • 2.

    中国医学科学院 北京协和医学院 北京协和医院放疗科, 北京 100730

基金项目: 

中央保健局基金 B2009B091

详细信息
    通讯作者:

    李汉忠  电话:010-65296035, E-mail:lihanzhong@medmail.com.cn

  • 中图分类号: R737.2;R454.9

Outcomes of Prostate Cancer Patients after Brachytherapy

  • 1.

    Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China

  • 2.

    Department of Radiotherapy, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China

More Information

    摘要
  • 摘要:   目的  探讨前列腺癌患者近距离治疗疗效及并发症。  方法  前列腺癌患者27例, 年龄63~81岁, 平均75岁。临床分期:T1cN0M016例, T2aN0M011例; Gleason评分:5分14例, 6分13例; 血清前列腺特异性抗原(prostate specific antigen, PSA)2.8~14.6 μg/L, 平均8.5 μg/L。采用125I粒子近距离治疗, 治疗剂量D90为140~155 Gy, 观察治疗疗效及并发症。27例患者治疗前后均未使用内分泌治疗。  结果  27例患者随访12~74个月, 平均44个月。近距离治疗后27例前列腺癌患者最低血清PSA中位数为0.18 μg/L, 2例患者最低血清PSA在1.0 μg/L以上; 治疗后1年患者血清PSA中位数为0.71 μg/L, 平均为0.92 μg/L, 17例患者血清PSA在1.0 μg/L以下; 2例患者分别于治疗后30及48个月出现生化复发, 复发率7%(2/27)。治疗后2例患者出现急性尿潴留, 予保留导尿1周后好转; 24例治疗后出现不同程度的尿路刺激症, 均在治疗后6~12个月内好转; 无1例出现前列腺直肠瘘。治疗前17例有勃起功能; 治疗后10例仍保留不同程度的勃起功能, 7例出现勃起功能障碍(占41%)。  结论  前列腺癌近距离治疗对于中低危前列腺癌疗效肯定, 并发症少, 多数患者可以保留性功能。
    Abstract:   Objective  To evaluate the effectiveness and complications of prostate brachytherapy.  Methods  We enrolled 27 prostate cancer patients aged 63 to 81 years(mean:75 years)in our study, with 16 at the clinical stage of T1cN0M0, 11 at T2aN0M0, and 14 with Gleason score of 5, 13 with Gleason score of 6. Their serum prostate specific antigen(PSA)levels ranged 2.8-18.6 μg/L(mean:8.5 μg/L). All of them underwent 125I seed implantation with the D90 of 140-155 Gy and had the serum PSA levels routinely determined after the procedure.Effectiveness and complications were also observed. None of the 27 patients were treated with hormone therapy.  Results  Follow-up ranged from 12 to 74 months(mean:44 months). The median nadir PSA was 0.18 μg/L, with only 2 above 1.0 μg/L. One year after brachytherapy, the median level of serum PSA was 0.71 μg/L(mean:0.92 μg/L), and 17 with the level under 1.0 μg/L. Two patients(7%)experienced biochemical failure at the 30 month and 48 month after the procedure. Two patients(7%)developed acute urinary retention, which was released after catheterization for 1 week. Low urinary tract symptoms were observed in 24 patients, which were improved 6-12 months later. No prostate-rectal fistula was observed. Seventeen patients erected efficiently before brachytherapy, while 10 preserved erection in different levels after brachytherapy. The incidence of erectile dysfunction was 41%(7/17).  Conclusion  Prostate brachytherapy is an effective treatment for low- and intermediate-risk patients with acceptable complications. Most patients can preserve sexual function after this procedure.
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    • 参考文献(14)
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出版历程
  • 收稿日期:  2010-11-05
  • 刊出日期:  2011-01-30

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