Okaneya Toshikazu, Nishizawa Shuji, Iijima Kazuyoshi, Yamagishi Takahiro, Kamigaito Takayuki, Hashida Iwao, Hosaka Noriko
The Department of Urology, Nagano Municipal Hospital.
Hinyokika Kiyo. 2012 Apr;58(4):185-91.
A total of 320 localized prostate cancer patients including 272 at low-risk and 48 at intermediate-risk were treated with permanent iodine-125 seed implants. Changes of lower urinary tract symptoms after the treatment were analyzed for one consecutive year using international prostate symptom score, quality of life (QOL) score and uroflowmetry. These patients did not have prostate hypertrophy or were not treated with any α1 blocker before the seed implant. Tamsulosin (0.2 mg/day) was prophylactically administered to all the patients for six months beginning the day after the seed implant. Both voiding and storage symptoms developed even in patients without any urinary symptoms before seed implant and worsened during the consecutive three months; and, QOL also worsened after seed implant. Lower urinary tract symptoms continued to be significantly severe for six months compared with that before the seed implant, then improved gradually to almost the initial level after one year. It seems to take longer for storage symptoms to diminish to the initial level compared with voiding symptoms. Neoadjuvant hormone therapy improved neither voiding nor storage symptoms in patients without prostate hypertrophy less than 40 ml in volume. In conclusion, a more effective α1 blocker or other potent prophylactic drug therapy should be used on the patients after seed implant because the disadvantage of seed implant is probably only urinary disturbance.
共有320例局限性前列腺癌患者接受了永久性碘-125粒子植入治疗，其中低危患者272例，中危患者48例。采用国际前列腺症状评分、生活质量（QOL）评分和尿流率测定，连续一年分析治疗后下尿路症状的变化。这些患者在粒子植入前没有前列腺增生，也未接受过任何α1受体阻滞剂治疗。从粒子植入后的第二天开始，所有患者预防性服用坦索罗辛（0.2毫克/天），持续六个月。即使在粒子植入前没有任何尿路症状的患者中，排尿和储尿症状也会出现，并在接下来的三个月内恶化；而且，粒子植入后生活质量也会恶化。与粒子植入前相比，下尿路症状在六个月内持续显著严重，然后在一年后逐渐改善至几乎初始水平。与排尿症状相比，储尿症状似乎需要更长时间才能减轻到初始水平。对于前列腺体积小于40毫升且无前列腺增生的患者，新辅助激素治疗对排尿和储尿症状均无改善。总之，粒子植入后的患者应使用更有效的α1受体阻滞剂或其他有效的预防性药物治疗，因为粒子植入的缺点可能仅为尿路干扰。
