| 摘要: |
| 目的探讨经直肠超声引导会阴穿刺组织间植入125I粒子在治疗高风险局限性前列腺癌中的临床疗效。方法将经前列腺穿刺活检确诊前列腺癌66例，TNM分期均为局限T3a期。其中125I粒子植入治疗组36例，腹腔镜根治术组30例。125I粒子植入治疗组在直肠超声引导下经会阴穿刺行125I粒子植入治疗术，术中由放射性粒子植入计划系统（TPS）指导。腹腔镜根治术组行腹腔镜前列腺癌根治术。观察两组患者生存指标及并发症、总前列腺抗原（T-PSA）变化情况及125I粒子植入治疗组对WBC、PLT的影响。结果125I粒子植入治疗组与腹腔镜根治术组无病生存期（DFS）、总生存期（OS）中位数比较均无统计学差异（均P＞0.05）；125I粒子植入治疗组术后无尿失禁、尿道狭窄发生，与腹腔镜根治术组比较均有统计学差异（均P＜0.05），尿道刺激征、尿储留发生率均无统计学差异（均P＞0.05）。125I粒子植入治疗组和腹腔镜根治术组术后3、6个月分别有33.33%（12/36）和73.33%（22/30）、83.33%（30/36）和80.00%（24/30）患者的T-PSA水平不能被检测出，达到生化检测无复发。125I粒子植入治疗组治疗后3、6个月WBC、PLT与治疗前比较均无统计学差异（均P＞0.05）。结论经直肠超声引导会阴穿刺组织间植入125I粒子治疗高风险局限性前列腺癌疗效确定，不良反应小，对骨髓造血活性无影响。 |
| 关键词: 前列腺肿瘤 近距离治疗 腹腔镜检查 前列腺癌根治术 |
| DOI：10.12056/j.issn.1006-2785.2017.39.24.2017-530 |
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| Efficacy of 125-iodine seeds branchytherapy for high-risk local prostate cancer |
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the First Affiliated Hospital，Zhejiang University School of Medicine
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| Abstract: |
| Objective To evaluate the clinical efficacy of transrectal ultrasound (TRUS)-guided transperineal permanent 125-iodine seeds branchytherapy for high-risk local prostate cancer. Methods Sixty six patients with biopsy-proven T3a prostate cancer admitted at the First Affiliated Hospital of Zhejiang Chinese Medical University between November 2013 and January 2016 were divided into two groups: 36 cases received TRUS-guided transperineal permanent 125-iodine seeds branchytherapy under the guidance of three-dimensional treatment planning system (TPS) and 30 cases received laparoscopic radical prostatectomy. The survival，complications and T-PSA levels in two groups were compared. Results There were no significant differences in median disease free survival (DFS) and overall survival (OS) between two groups (P ＞0.05). The postoperative uroclepsia and urethrostenosis were not observed in branchytherapy group, which were significantly better than
those in prostatectomy group (P＜0.05). However, there were no significant differences in urethra irritation and urinary retention between two groups (P ＞0.05). T-PSA did not detected in 33.3%(12/36) and 83.3%(30/36)patients of branchytherapy group, and 73.33% (22/30) and 80.00% (24/30) patients of prostatectomy group at 3 and 6 months after operation, reaching biochemical recurrence-free survival. The WBC and PLT levels had no significant changes in branchytherapy group at 3 and 6 months after operation, compared with those before operation (P ＞0.05). Conclusion TRUS-guided transperineal permanent 125-iodine
seeds branchytherapy is effective and safe for patients with high-risk local prostate cancer. |
| Key words: Prostatic neoplasms Branchytherapy Laparoscopy Radical prostatectomy |
