CAJ | 학술논문

目的探讨早期前列腺癌近距离照射治疗的远期疗效及并发症. 方法 2003年12月至2007年12月138例早期前列腺癌患者接受近距离照射治疗,其中117例随访资料完整,年龄51～84岁,平均73岁;PSA 0.4～47.6 μg/L,平均14.7 μg/L;Gleason评分4～9,平均6.4;临床分期Tib ～T2.;前列腺体积13～69 ml,平均31 ml;穿刺阳性率8％～ 100％,平均45％.其中低、中、高危前列腺癌分别为22、29、66例.观察其无生化复发率、总体生存率及并发症情况. 结果随访19～114个月,平均84个月.33例出现生化复发,无生化复发率72％.死亡12例,其中4例死于前列腺癌,7年总体生存率90％,肿瘤特异性生存率97％.低、中、高危组的7年无生化复发率分别为86％、79％及64％,组间差异有统计学意义(P=0.040);总体生存率分别为100％、90％及86％,组间差异无统计学意义(P=0.189).发生尿潴留11例,占9％,其中1例行TURP治疗.未出现前列腺直肠瘘等严重并发症. 结论早期前列腺癌近距离照射治疗的长期疗效肯定,平均随访7年无生化复发率为72％,总体生存率90％,并发症少.
목적 탐토조기전렬선암근거리조사치료적원기료효급병발증. 방법 2003년12월지2007년12월138례조기전렬선암환자접수근거리조사치료,기중117례수방자료완정,년령51～84세,평균73세;PSA 0.4～47.6 μg/L,평균14.7 μg/L;Gleason평분4～9,평균6.4;림상분기Tib ～T2.;전렬선체적13～69 ml,평균31 ml;천자양성솔8％～ 100％,평균45％.기중저、중、고위전렬선암분별위22、29、66례.관찰기무생화복발솔、총체생존솔급병발증정황. 결과 수방19～114개월,평균84개월.33례출현생화복발,무생화복발솔72％.사망12례,기중4례사우전렬선암,7년총체생존솔90％,종류특이성생존솔97％.저、중、고위조적7년무생화복발솔분별위86％、79％급64％,조간차이유통계학의의(P=0.040);총체생존솔분별위100％、90％급86％,조간차이무통계학의의(P=0.189).발생뇨저류11례,점9％,기중1례행TURP치료.미출현전렬선직장루등엄중병발증. 결론 조기전렬선암근거리조사치료적장기료효긍정,평균수방7년무생화복발솔위72％,총체생존솔90％,병발증소.
Objective To investigate the long-term efficacy and complications of brachytherapy in early stage prostate cancer.Methods The data of 117 cases of early stage prostate cancer patients were analyzed,aged from 51 to 84 years,with an average of 73 years.The PSA ranged from 0.4 to 47.6 μg/L (14.7 in average),Gleason score ranged from 4 to 9 (6.4 in average),clinical stage ranged from T1b to T2c,the prostate volume ranged from 13 to 69 ml (31 ml in average),and the positive biopsy rate was 8％to 100％ (45％ in average).The low-risk,intermediate-risk and high-risk prostate cancer were 22,29 and 66 cases.Biochemical no evidence of disease (bNED),overall survival and complications were recorded.Results Followed up from 19 to 114 months (84 months in average),33 cases had biochemical recurrence (bNED rate,72％).Twelve patients died,among which 4 patients died of prostate cancer.The overall survival rate was 90％,and the cancer-specific survival rate was 97％.The bNED rates in low-risk,intermediate-risk and high-risk groups were 86％,79％ and 64％,and the difference was significant among the 3groups (P=0.040).The overall survival rates were 100％,90％ and 86％,with no significant difference among the 3 groups (P=0.189).Urinary retention occurred in 11 cases (9％),among which 1 patient had TURP treatment.No serious complications such as rectal fistula occurred.Conclusions The long-term efficacy of brachytherapy in early stage prostate cancer is definite with few complications.With a mean followup of 7 years,the bNED rate was 72％ and the overall survival rate was 90％.