Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, the Netherlands.
Radiother Oncol. 2010 Jul;96(1):30-3. doi: 10.1016/j.radonc.2010.02.012. Epub 2010 Mar 8.
To assess clinical outcome in terms of biochemical No evidence of disease (bNED) for patients with stranded seed implants versus loose seed implants in prostate brachytherapy.
From December 2000 until October 2006, we treated 896 T< or =2C Nx/0 Mx/0, prostate cancer patients with either stranded seed (n=538) or loose seed (n=358) I-125 implants. A total of 211 patients received a 6 months course of anti-androgen therapy, before treatment, for prostate volume reduction to <50 cc. Patients with very small and large gland volumes or a history of transurethral prostate resection, were preferably treated with stranded seeds, otherwise selection was arbitrary.
The 5-year bNED rates (95% Confidence Interval) for stranded seed patients and loose seed patients were respectively 86% (82-90) and 90% (85-95), the total 5-year bNED rate was 87% (85-90). When adjusted for possible confounding factors in a Cox-regression analysis, type of seed was significantly associated with biochemical failure with a 43% risk reduction (hazard ratio: 0.57; 95% CI: 0.34-0.97) for loose seeds versus stranded seeds.
These results suggest that seed-type affects clinical outcome in prostate brachytherapy, with better bNED for patients with loose seed implants.
评估 stranded 种子植入与 loose 种子植入前列腺近距离放射治疗中患者生化无病（bNED）的临床结果。
从 2000 年 12 月至 2006 年 10 月，我们治疗了 896 例 T<或=2C Nx/0 Mx/0、前列腺癌患者，他们分别接受了 stranded 种子（n=538）或 loose 种子（n=358）I-125 植入。共有 211 例患者接受了 6 个月的抗雄激素治疗，以降低前列腺体积至<50 cc，以避免前列腺体积过大或过小或有经尿道前列腺切除术史的患者。对于体积较小或较大的前列腺或有经尿道前列腺切除术史的患者，优选使用 stranded 种子，否则则根据情况进行选择。
stranded 种子患者和 loose 种子患者的 5 年 bNED 率（95%置信区间）分别为 86%（82-90）和 90%（85-95），总 5 年 bNED 率为 87%（85-90）。在 Cox 回归分析中调整可能的混杂因素后，种子类型与生化失败显著相关，loose 种子的风险降低了 43%（危险比：0.57；95%置信区间：0.34-0.97）。
这些结果表明，种子类型影响前列腺近距离放射治疗的临床结果，loose 种子植入的患者 bNED 更好。
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