论文部分内容阅读
目的:探讨~(125)Ⅰ粒子植入术联合手术去势治疗局部晚期前列腺癌的临床效果。方法:采用直肠B超引导下经会阴植入~(125)Ⅰ粒子并同时行双侧睾丸切除术治疗晚期前列腺癌患者40例,年龄52～87岁,平均73岁;Gleason评分为3～9分,PSA检测为0.24～2736.46 ng/ml,临床分期为T_3N_0M_0。结果:所有患者手术过程顺利,平均植入粒子71±15粒。术后随访10～76个月,中位随访时间44.5个月。远期手术并发症(>1年)尿失禁发生率为2.5%(1/40),轻度血便发生率为10%(4/40),尿道直肠瘘发生率为2.5%(1/40)。1例在术后69个月死亡,有5例在术后平均15.8个月出现PSA生化复发,累计PSA无进展患者生存率为86.9%。结论:运用~(125)Ⅰ粒子植入术联合手术去势术治疗局部晚期前列腺癌患者长期并发症少,临床效果良好。
Objective: To investigate the clinical effect of ~ (125) Ⅰ particle implantation combined with surgical castration in the treatment of locally advanced prostate cancer. Methods: Forty patients with advanced prostate cancer who underwent transrectal B-guided perineal implantation of ~ (125) Ⅰ particles and bilateral orchiectomy were enrolled in this study. The mean age was from 52 to 87 years old with an average of 73 years old. The Gleason score ranged from 3 to 9 Points, PSA test was 0.24 ~ 2736.46 ng / ml, clinical stage T_3N_0M_0. RESULTS: All patients underwent a successful surgical procedure with an average implantation of 71 ± 15 particles. The patients were followed up for 10 to 76 months and the median follow-up time was 44.5 months. The incidence of urinary incontinence was 2.5% (1/40), mild bloody stool was 10% (4/40) and urethral rectal fistula was 2.5% (1/40) in long-term surgical complications (> 1 year) . One patient died at 69 months after operation, and 5 patients had PSA biochemical recurrence 15.8 months after operation. The cumulative survival rate of patients with no PSA progression was 86.9%. Conclusion: The application of ~ (125) Ⅰ particle implantation combined with surgical castration in the treatment of locally advanced prostate cancer has less long-term complications and good clinical effect.