Royal Surrey County Hospital, Department of Urology, Guildford, Surrey, UK.
BJU Int. 2012 Apr;109(7):994-1000. doi: 10.1111/j.1464-410X.2011.10460.x. Epub 2011 Aug 19.
To report on the long-term toxicity outcome for patients with prostate cancer treated by low-dose rate (LDR) brachytherapy (BXT).
The study population comprised a cohort of men treated in our centre between March 1999 and April 2004 with LDR BXT for prostate cancer who had at least 5 years of follow-up post-implant. Patients who had died or experienced biochemical failure were excluded. We contacted eligible patients and asked them to complete a questionnaire to assess current urinary, erectile and bowel function. Urinary and erectile function was compared pre- and post-treatment and outcomes were assessed by treatment modality.
Of the 226 LDR BXT-treated patients with >5 years of follow-up, 174 (77.0%) responded to the questionnaire. The mean International Prostate Symptom Score (IPSS) increased from 6.70 pre-BXT to 7.91 at follow-up (P = 0.003). Of the patients with mild symptoms pre-BXT (IPSS, 0-7), 64.2% retained mild symptoms at follow-up, 31.2% developed moderate symptoms (IPSS, 8-9) and 4.6% reported severe symptoms (IPSS, 20-35). A good or acceptable quality of life (QoL) secondary to urinary symptoms (IPSS QoL, 0-4) was reported by 98.0% of respondents. Of those patients potent (International Index of Erectile Function-5 ≥11) pre-BXT, 62.9% remained potent at follow-up. There were no differences in the proportion of patients who were potent when analyzed by the number of years post-implant. At follow-up, 51.7% and 45.4% of patients, respectively, had normal or mild bowel symptoms as indicated by the European Organisation for the Research and Treatment of Cancer questionnaire (QLQ-C30/PR25 scores, 4-8). Moderate bowel symptoms (QLQ-C30/PR25 scores, 9-12) were reported by 2.9% of respondents; none reported severe symptoms.
The present study shows low morbidity after LDR BXT over the long-term for a large cohort of patients.
报告低剂量率（LDR）近距离放射治疗（BXT）治疗前列腺癌患者的长期毒性结果。
研究人群包括 1999 年 3 月至 2004 年 4 月在我们中心接受 LDR BXT 治疗的前列腺癌患者队列，这些患者在植入后至少有 5 年的随访。排除已死亡或发生生化失败的患者。我们联系了符合条件的患者，并要求他们填写一份问卷，以评估当前的尿、勃起和肠道功能。比较治疗前后的尿和勃起功能，并根据治疗方式评估结果。
在 226 名接受 LDR BXT 治疗且随访时间超过 5 年的患者中，有 174 名（77.0%）回答了问卷。国际前列腺症状评分（IPSS）从 BXT 前的 6.70 分增加到随访时的 7.91 分（P=0.003）。在 BXT 前有轻度症状（IPSS，0-7）的患者中，64.2%在随访时仍保持轻度症状，31.2%发展为中度症状（IPSS，8-9），4.6%报告有严重症状（IPSS，20-35）。98.0%的应答者报告由于尿症状（IPSS QoL，0-4）而导致的生活质量（QoL）较好或可接受。在 BXT 前有勃起功能（国际勃起功能指数-5≥11）的患者中，62.9%在随访时仍有勃起功能。按植入后年限分析，有勃起功能的患者比例无差异。在随访时，分别有 51.7%和 45.4%的患者根据欧洲癌症研究与治疗组织问卷（QLQ-C30/PR25 评分，4-8）报告有正常或轻度肠道症状。2.9%的应答者报告有中度肠道症状（QLQ-C30/PR25 评分，9-12）；没有人报告有严重症状。
本研究显示，对于大量患者，LDR BXT 的长期治疗后发病率较低。
