Department of Urology and Radiation Oncology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
BJU Int. 2009 Dec;104(11):1620-3. doi: 10.1111/j.1464-410X.2009.08664.x. Epub 2009 Jul 16.
To analyse retrospectively the morbidity and efficacy of high-dose rate (HDR) brachytherapy in patients who had a previous transurethral resection of the prostate (TURP).
Morbidities documented in the records of 32 patients with previous TURP and 106 with no previous TURP, treated with HDR brachytherapy for prostate cancer at our institution, were analysed and compared. All patients received HDR brachytherapy as a boost before conformal external beam radiotherapy. We recorded and analysed genitourinary complications, rectal morbidity, and the biochemical control rate as assessed by the prostate-specific antigen (PSA) level.
All complications of patients who received HDR brachytherapy were recorded during the follow-up. All gastrointestinal and genitourinary complications were not significantly different in patients with or without previous TURP. There was little incontinence or severe morbidity associated with HDR brachytherapy. The PSA-based biochemical control rates were similar in patients with or without previous TURP in each risk group.
HDR brachytherapy is a reasonable treatment for localized prostate cancer in patients who have had a previous TURP, with the expectation of low morbidity and satisfactory biochemical control.
回顾性分析既往经尿道前列腺切除术（TURP）患者接受高剂量率（HDR）近距离放疗的发病率和疗效。
分析了本机构收治的 32 例既往行 TURP 和 106 例无 TURP 史的前列腺癌患者接受 HDR 近距离放疗的记录，并进行了比较。所有患者均在接受适形外照射放疗前接受 HDR 近距离放疗作为增敏治疗。我们记录并分析了泌尿生殖系统并发症、直肠发病率以及前列腺特异性抗原（PSA）水平评估的生化控制率。
所有接受 HDR 近距离放疗的患者的并发症均在随访期间记录。既往有 TURP 史和无 TURP 史患者的胃肠道和泌尿生殖系统并发症无显著差异。HDR 近距离放疗后仅有轻微尿失禁或严重并发症。在每个风险组中，既往有 TURP 史和无 TURP 史患者的 PSA 生化控制率相似。
对于既往接受过 TURP 的局限性前列腺癌患者，HDR 近距离放疗是一种合理的治疗方法，预期发病率低，生化控制满意。
