Vijverberg P L, Kurth K H, Blank L E, Dabhoiwala N F, de Reijke T H, Koedooder K
Department of Urology, University of Amsterdam, The Netherlands.
Eur Urol. 1992;21(1):35-41. doi: 10.1159/000474797.
Treatment of localized prostate cancer by ultrasonically guided transperineal 125I implantation, in contrast to open 125I implantation, may allow for ideal distribution of the seeds and may therefore lead to better treatment results. 46 patients with localized prostatic carcinoma (T1-T2, G1-G3, N0, M0) have been treated since 1985, using this new technique. The longest follow-up is 64 months (median 30 months). The irradiation implantation dose to the prostate was 160 Gy. Assessed by ultrasonography an average prostate volume reduction of 20% was achieved at 6 months, increasing to 24% at 12 months, 39% at 24 months and 56% at 48 months. To evaluate response of the primary tumor systematic ultrasonically guided needle biopsies from the previous malignant prostate areas were performed in all patients every 6 months during follow-up. Tumor-negative biopsies were obtained in 33% of patients at 12 months, 40% at 24 months, progressively increasing to 50% at 48 months. Three patients developed distant metastases, and 6 died, of whom 1 patient due to prostate cancer. Morbidity from implantation has been low and the erectile function was preserved in all patients at 12 months postimplantation. The high percentage of tumor-positive biopsies during follow-up indicates that this technique fails to cure a significant proportion of patients.
与开放性¹²⁵I植入相比，超声引导下经会阴¹²⁵I植入治疗局限性前列腺癌可使粒子分布更理想，从而可能带来更好的治疗效果。自1985年以来，已有46例局限性前列腺癌患者（T1-T2，G1-G3，N0，M0）采用这项新技术进行了治疗。最长随访时间为64个月（中位时间30个月）。前列腺的照射植入剂量为160Gy。通过超声评估，6个月时前列腺体积平均缩小20%，12个月时增至24%，24个月时为39%，48个月时为56%。为评估原发肿瘤的反应，在随访期间，对所有患者每6个月从前列腺恶性区域进行一次系统的超声引导下穿刺活检。12个月时，33%的患者活检结果为肿瘤阴性，24个月时为40%，至48个月时逐渐增至50%。3例患者发生远处转移，6例死亡，其中1例死于前列腺癌。植入的并发症发生率较低，所有患者在植入后12个月时勃起功能均得以保留。随访期间肿瘤阳性活检的高比例表明，这项技术无法治愈相当一部分患者。
