CAJ | 학술논문

目的回顾性分析125I粒子植入联合内分泌治疗T3N0M0期前列腺癌的疗效和不良反应.方法临床分期为T3N0M0前列腺癌患者22例,行经直肠超声引导125I粒子植入联合内分泌治疗.靶区最小周边剂量为140 ～160 Gy,尿道剂量＜400 Gy.中位粒子数74颗(26～ 90颗),中位粒子活度1.55×107 Bq(1.30×107～ 1.85×107) Bq.11例行去势手术,11例行药物去势联合抗雄激素治疗.结果 22例患者均顺利完成粒子植入治疗.5年无生化失败生存率为70.6％,总生存率为81.8％.2例于粒子植入术后12个月出现生化失败,1例在术后90个月出现生化失败,重新给予内分泌治疗.粒子植入治疗后1级、2级尿道不良反应发生率分别为54.5％、9.1％,1级和2直肠不良反应发生率分别为22.7％和9.1％,1例出现4级直肠反应.结论放射性125I粒子植入联合内分泌治疗T3N0M0期前列腺癌创伤小、疗效好,可以考虑应用于不愿接受外放疗的患者.
목적 회고성분석125I입자식입연합내분비치료T3N0M0기전렬선암적료효화불량반응.방법 림상분기위T3N0M0전렬선암환자22례,행경직장초성인도125I입자식입연합내분비치료.파구최소주변제량위140 ～160 Gy,뇨도제량＜400 Gy.중위입자수74과(26～ 90과),중위입자활도1.55×107 Bq(1.30×107～ 1.85×107) Bq.11례행거세수술,11례행약물거세연합항웅격소치료.결과 22례환자균순리완성입자식입치료.5년무생화실패생존솔위70.6％,총생존솔위81.8％.2례우입자식입술후12개월출현생화실패,1례재술후90개월출현생화실패,중신급여내분비치료.입자식입치료후1급、2급뇨도불량반응발생솔분별위54.5％、9.1％,1급화2직장불량반응발생솔분별위22.7％화9.1％,1례출현4급직장반응.결론 방사성125I입자식입연합내분비치료T3N0M0기전렬선암창상소、료효호,가이고필응용우불원접수외방료적환자.
Objective To retrospectively study the efficacy and side-effect of 125I seed implantation combined with endocrinal therapy in stage T3N0M0 prostate cancer.Methods The study included 22 patients with clinical stage T3 N0 M0 prostate cancer who were treated with transperineal 125I seed implantation guided by transrectal ultrasound,real time TPS and endocrinal therapy.The minimum peripheral doses (MPD) were 140-160 Gy.The median number of seeds was 74(26-90).The activity of each seed was 1.55 × 107 (1.30 × 107-1.85 × 107) Bq.11 patients were treated with orchidectomy,and 11 patients were treated with androgen deprivation therapy.Results All 22 patients completed the seed implantation successfully.The 5-year biochemical progression-free survival was 70.6％,and 5-year overall survival was 81.8％.2 patients were found biochemical failure in 12 months after seed implantation,and another 1 patient failed in 90 months.Endocrinal therapy was followed thereafter.After the seed implantation,the urinary complications of grade 1 and 2 were 54.5％ and 9.1％ respectively,and the rectum side-effect of grade 1 and 2 were 22.7％ and 9.1％.1 patient suffered rectal complication of grade 4.Conclusions Good effect and tolerance are observed in prostate cancer patients of stage T3N0M0 receiving 125I seed implantation plus endocrinal therapy.The treatment can be considered for those who refuse to receive external beam radiotherapy.