对于低风险前列腺癌患者，使用碘-125粒子进行低剂量率近距离放射治疗具有出色的5年治疗效果，且副作用较少。
Low-dose rate brachytherapy with I-125 seeds has an excellent 5-year outcome with few side effects in patients with low-risk prostate cancer.
作者信息
Rasmusson Elisabeth, Gunnlaugsson Adalsteinn, Kjellén Elisabeth, Nilsson Per, Einarsdottir Margret, Wieslander Elinore, Fransson Per, Ahlgen Göran, Blom René
机构信息
a Department of Oncology and Radiation Physics , Skåne University Hospital, Lund University , Lund , Sweden ;
b Department of Nursing , Umeå University , Umeå , Sweden ;
出版信息
Acta Oncol. 2016 Aug;55(8):1016-21. doi: 10.1080/0284186X.2016.1175659. Epub 2016 May 13.
BACKGROUND
Low-dose rate brachytherapy (LDR-BT) has been used in Sweden for more than a decade for treatment of low-risk prostate cancer. This study presents the outcome for patients treated with LDR-BT at a single institution with focus on the association between dose and biochemical failure-free survival (BFFS).
METHODS
In total 195 patients were treated with LDR-BT between 2004 and 2008. The patients were followed systematically for side effects for at least one year. PSA levels were followed regularly from three months and for at least five years. Outcome was analyzed in relation to clinical variables at baseline and to radiotherapy data.
RESULTS
Kaplan-Meier estimated BFFS at five years was 95.7%. Dose to the prostate in terms of D90% was significantly associated with BFFS [HR 0.90 (95%CI 0.83-0.96), p = 0.002].
CONCLUSION
Out data confirmed that absorbed dose is a predictive factor for BFFS for low-risk patients without androgen deprivation therapy. With our treatment routines and dosimetry, a D90% in the range of 170-180 Gy gives excellent outcomes with acceptable toxicity for patients with low-risk prostate cancer.
背景
低剂量率近距离放射治疗（LDR-BT）在瑞典已用于治疗低风险前列腺癌超过十年。本研究呈现了在单一机构接受LDR-BT治疗患者的结果，重点关注剂量与无生化失败生存率（BFFS）之间的关联。
方法
2004年至2008年间共有195例患者接受了LDR-BT治疗。对患者进行了至少一年的系统副作用随访。从三个月开始定期随访PSA水平，持续至少五年。根据基线临床变量和放疗数据对结果进行分析。
结果
五年时Kaplan-Meier估计的BFFS为95.7%。以D90%表示的前列腺剂量与BFFS显著相关[风险比0.90（95%置信区间0.83-0.96），p = 0.002]。
结论
我们的数据证实，对于未接受雄激素剥夺治疗的低风险患者，吸收剂量是BFFS的预测因素。按照我们的治疗程序和剂量测定法，对于低风险前列腺癌患者，170-180 Gy范围内的D90%可带来优异的结果，且毒性可接受。
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