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目的探讨~(125)I放射粒子植入治疗局限性前列腺癌的疗效和并发症。方法回顾分析2010年3月至2014年5月我院15例接受~(125)I放射粒子植入治疗的、局限性前列腺癌内放疗患者的临床资料。年龄69~80岁,平均年龄(76.4±6.9)岁。临床分期:T1N0M0期8例,T2N0M0期7例。Gleason评分≤6分11例,7分4例。12例术前前列腺特异性抗原(PSA)介于10~20ng/mL之间,3例PSA<10ng/mL。术后随访观察尿路及直肠等并发症发生情况及PSA的变化。结果 15例患者术后均恢复良好。术后出现尿急、尿痛等下尿路刺激症状8例,给予对症处理,4个月后症状逐渐消失;未发现尿失禁及直肠溃疡等严重并发症;术后6个月患者血清PSA 0.98~4.3ng/mL,平均(2.8±1.6)ng/mL,与术前比较差异有统计学意义(p=0.02);术后1年所有患者PSA均降至2ng/mL以下并维持在较低水平;随访1年到5年,患者均健在,生活自理。结论 ~(125)I放射粒子植入治疗局限性前列腺癌安全、有效。
Objective To investigate the efficacy and complications of 125 I radioactive particle implantation in the treatment of localized prostate cancer. Methods From March 2010 to May 2014, the clinical data of 15 patients with locally advanced prostate cancer undergoing radiotherapy with ~ (125) I radioactive particles in our hospital were retrospectively analyzed. Age 69 to 80 years, mean age (76.4 ± 6.9) years old. Clinical stage: T1N0M0 8 cases, T2N0M0 7 cases. Gleason score ≤ 6 points in 11 cases, 7 points in 4 cases. Preoperative prostate specific antigen (PSA) ranged from 10 to 20 ng / mL in 12 patients and PSA <10 ng / mL in 3 patients. Postoperative follow-up observation urinary tract and rectum complications and PSA changes. Results All 15 patients recovered well after operation. Postoperative urinary urgency, dysuria and other lower urinary tract irritation in 8 cases, given symptomatic treatment, 4 months after the symptoms gradually disappear; found no urinary incontinence and rectal ulcer and other serious complications; 6 months after the patient serum PSA 0.98 ~ 4.3 ng / mL, with an average of (2.8 ± 1.6) ng / mL, which was significantly different from preoperative values (p = 0.02); PSA decreased to below 2 ng / mL at 1 year postoperatively Level; follow-up of 1 to 5 years, patients are alive, self-care. Conclusion ~ 125 I radioactive particle implantation is safe and effective in the treatment of localized prostate cancer.