Potters L
Department of Radiation Oncology, Memorial Sloan Kettering at Mercy Medical Center, Rockville Centre, New York 11570, USA.
Clin Oncol (R Coll Radiol). 2003 Sep;15(6):301-15. doi: 10.1016/s0936-6555(03)00152-3.
Permanent prostate brachytherapy techniques are associated with excellent biochemical control for patients with localised prostate cancer. Ten-year data show that permanent prostate brachytherapy is compatible with external beam irradiation or radical prostatectomy. However, treatment protocols and techniques for prostate brachytherapy vary between centres and there is little conformity of treatment protocols. The selection of patients for monotherapy or combined external beam irradiation and brachytherapy is controversial. The role of neoadjuvant androgen deprivation also remains unanswered in patients with localised prostate cancer. In addition, post-implant dosimetry may in fact be more significant for predicting outcome than the addition of adjuvant therapies, and should be a requirement when performing prostate brachytherapy. Data now seem to support specific computed tomography (CT)-based criteria to evaluate implant quality and delivered dose to the prostate. Unfortunately, prostate oedema and poor imaging techniques are limiting factors for evaluating implant dosimetry. Treatment planning techniques that use new treatment planning computers may assist in improving the implant procedure and dosimetry and are now available.
永久性前列腺近距离放射治疗技术对于局限性前列腺癌患者而言，与出色的生化控制效果相关。十年数据表明，永久性前列腺近距离放射治疗与外照射放疗或根治性前列腺切除术效果相当。然而，各中心之间前列腺近距离放射治疗的治疗方案和技术存在差异，治疗方案几乎没有一致性。选择患者进行单一疗法或联合外照射放疗与近距离放射治疗存在争议。新辅助雄激素剥夺在局限性前列腺癌患者中的作用也尚无定论。此外，植入后剂量测定实际上对于预测预后可能比添加辅助治疗更为重要，并且在进行前列腺近距离放射治疗时应作为一项要求。目前的数据似乎支持基于特定计算机断层扫描（CT）的标准来评估植入质量和前列腺所接受的剂量。不幸的是，前列腺水肿和不良的成像技术是评估植入剂量测定的限制因素。使用新型治疗计划计算机的治疗计划技术可能有助于改进植入程序和剂量测定，并且目前已有此类技术。
