Rodriguez R R, Demanes D J, Altieri G A
California Endocurietherapy Cancer Center, Summit Medical Center, Oakland, California, USA.
Hematol Oncol Clin North Am. 1999 Jun;13(3):503-23. doi: 10.1016/s0889-8588(05)70071-x.
Because the HDR brachytherapy treatments are delivered within minutes and on an outpatient basis, HDR brachytherapy is very well tolerated by patients and offers complete radiation safety. Published studies2, 11, 12, 13, 16, 17, 18, 22, 24, 25 have shown high local clinical and biochemical control rates. Chronic complications have been acceptably low. Very low rates of urinary incontinence and high sexual potency rates have been reported. Gastrointestinal morbidity has been minimal. The development of Ir-192 HDR afterloading brachytherapy and refinements in the dosimetry have ushered in a new era in prostate brachytherapy. The control of the radiation dose and the ability to shape the radiation treatment envelope using a stepping source have allowed a giant step forward in radiation oncology technology. It is now possible to deliver tumoricidal doses of radiation conformally to the prostate while minimizing the dose to the bladder, urethra, and rectum. At present, HDR afterloaded brachytherapy is the optimal whole-organ and tumor-specific conformal radiation therapy for prostate cancer.
由于高剂量率近距离放射治疗在数分钟内即可完成且为门诊治疗，患者对其耐受性良好，并且具有完全的放射安全性。已发表的研究2、11、12、13、16、17、18、22、24、25表明局部临床和生化控制率很高。慢性并发症发生率一直处于可接受的低水平。据报道，尿失禁发生率极低，性功能保持率很高。胃肠道发病率极低。铱-192高剂量率后装近距离放射治疗的发展以及剂量测定技术的改进开创了前列腺近距离放射治疗的新纪元。通过步进源控制辐射剂量以及塑造放射治疗范围的能力，使放射肿瘤学技术向前迈出了巨大的一步。现在可以将杀灭肿瘤的辐射剂量适形地传递至前列腺，同时将对膀胱、尿道和直肠的剂量降至最低。目前，高剂量率后装近距离放射治疗是前列腺癌最佳的全器官和肿瘤特异性适形放射治疗。
