Department of Radiation Oncology, Emory University School of Medicine, GA 30322, USA.
J Natl Med Assoc. 2010 Jun;102(6):500-10. doi: 10.1016/s0027-9684(15)30559-9.
Prostate cancer is the most common male cancer in the United States and the second leading cause of male cancer death. The main therapeutic modalities for the treatment of prostate cancer are surgery, external beam radiation therapy, hormonal therapy, and brachytherapy. In recent years, brachytherapy has been increasingly utilized for the treatment of early-stage prostate cancer. Technological advances, including improvements in imaging, planning, and postimplant quality assessment by dosimetry have led to widespread use of brachytherapy. Outcomes for prostate brachytherapy have been shown to be equivalent, in selected patients, to those of other treatment modalities for prostate cancer, including radical prostatectomy and external beam radiation therapy. Further, prostate brachytherapy has quality-of-life benefits in comparison to these other treatment modalities, particularly in the domain of sexual function. This paper describes the history of low-dose rate brachytherapy; current techniques for brachytherapy implantation and postoperative dosimetric evaluation; recent outcomes studies; recent quality-of-life analyses; and current and future prostate brachytherapy developments, including open clinical trials. As research in prostate brachytherapy continues, it is likely that this modality will play an increasingly important role in the treatment of early-stage prostate cancer patients in the future.
前列腺癌是美国最常见的男性癌症，也是男性癌症死亡的第二大主要原因。前列腺癌的主要治疗方式包括手术、外束放射治疗、激素治疗和近距离放射治疗。近年来，近距离放射治疗越来越多地用于治疗早期前列腺癌。技术进步，包括影像学、计划和剂量学评估方面的改进，导致了近距离放射治疗的广泛应用。在选择合适的患者中，前列腺近距离放射治疗的结果与前列腺癌的其他治疗方式（包括根治性前列腺切除术和外束放射治疗）相当。此外，与这些其他治疗方式相比，前列腺近距离放射治疗在生活质量方面具有优势，特别是在性功能方面。本文描述了低剂量率近距离放射治疗的历史；近距离放射治疗植入和术后剂量学评估的当前技术；最近的结果研究；最近的生活质量分析；以及当前和未来的前列腺近距离放射治疗发展，包括开放临床试验。随着对前列腺近距离放射治疗的研究不断深入，该治疗方式在未来可能会在治疗早期前列腺癌患者方面发挥越来越重要的作用。
