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目的 :探讨超声引导放射性 12 5I粒子植入治疗复发前列腺癌。方法 :8例前列腺癌去势术后复发实施超声引导放射性 12 5I粒子植入治疗。 2例单纯粒子植入治疗 ,肿瘤匹配周边剂量为 (matchedpe ripheraldose ,MPD) 90～ 14 5Gy ,2例先行外放疗 ,外放疗剂量为 4 0～ 4 5Gy。粒子活度 0 35～ 0 4 0mCi。随访 3～ 2 9个月 ,连续 3次前列腺特异抗原 (prostatespecificantigen ,PSA)升高即为生物化学失败 (bio chemicalfailure)。结果 :粒子治疗前后PSA分别为 (7 5 3± 7 6 4)ng mL和 (1 2 5± 1 19)ng mL ,统计学处理明显下降 ,t=2 2 97,P =0 0 38。 2例生物化学失败 ,生物化学控制率 (biochemicalcontrolrate)为 6 8例 ,1例出现 1级泌尿道并发症 ,1例出现 2级泌尿道并发症。 1 8例患者粒子发生移位 ,但是并没有引起临床相关并发症 ,没有粒子移位到肺。结论 :超声引导经会阴放射性 12 5I粒子植入治疗复发前列腺癌具有安全、微创、并发症发生率低和疗效肯定 ,是一种较理想的补救治疗手段。
Objective: To investigate the ultrasound-guided radioactive 125I seed implantation in the treatment of recurrent prostate cancer. Methods: 8 cases of prostate cancer recurrence after castration implementation of ultrasound-guided radioactive 125I seed implantation. Two patients were treated with simple particle implantation. The matched dose (90 ~ 145 Gy) of matchedperipheraldose (MPD) was given in 2 cases. The external radiotherapy dose was 40 ~ 45 Gy. Particle activity 0 35 ~ 0 4 0mCi. Followed up for 3 to 29 months, three consecutive times of prostate specific antigen (prostatespecificantigen, PSA) is biochemical failure (bio chemicalfailure). Results: Before and after the treatment, PSA was (753 ± 7 6 4) ng mL and (125 ± 1 19) ng mL, respectively, and the statistical difference was statistically significant (t = 2 2 97, P = 0 0 38). Two patients had failed biochemical control. The biochemical control rate was 68. One patient had grade 1 urinary tract complications and one patient had grade 2 urinary tract complications. In 18 patients the particles were displaced, but did not cause clinically relevant complications and no particles were translocated to the lungs. CONCLUSIONS: Ultrasound guided transperineal radioactive 125I seed implantation in the treatment of recurrent prostate cancer is safe and minimally invasive with low complication rate and definite therapeutic effect. It is an ideal remedy.