Srougi Victor, Barret Eric, Nunes-Silva Igor, Baghdadi Mohammed, Garcia-Barreras Silvia, Pierrat Noelle, Rozet Francois, Galiano Marc, Sanchez-Salas Rafael, Cathelineau Xavier, Cosset Jean-Marc
Department of Urology, Institut Montsouris, Université Paris-Descartes, Paris, France; Division of Urology, University of Sao Paulo, Sao Paulo, Brazil.
Department of Urology, Institut Montsouris, Université Paris-Descartes, Paris, France.
Brachytherapy. 2017 Sep-Oct;16(5):988-992. doi: 10.1016/j.brachy.2017.05.009. Epub 2017 Jun 23.
To evaluate whether patients with prostate cancer have worse functional urinary recovery with focal brachytherapy (FBT) at the base versus the apex of the prostate.
The functional outcomes of patients treated with FBT at the base of the prostate were compared with those of patients treated with FBT at the apex. Urinary symptoms, continence, and erectile dysfunction were measured using the International Prostate Symptom Score (IPSS), International Continence Score (ICS), and International Index of Erectile Function (IIEF-5) questionnaires, respectively, at baseline and at 6, 12, and 24 months after treatment.
Twenty-eight and 13 patients were treated with FBT at the apex and the base, respectively, of the prostate. A significant difference between groups was found in the IPSS score at 6 months (mean IPSS: apex 6.4 ± 4.7, base 10.6 ± 5.7; p = 0.02), but not at baseline or at 12 and 24 months after treatment. On multivariate analysis, only FBT at the base of the prostate remained an independent predictor of worsening urinary symptoms (odds ratio, 5.8; p = 0.04).
At 6 months after FBT, significantly less urinary toxicity was found in patients who underwent FBT at the apex versus the base of the prostate. Continence and sexual side effects were minimal in all patients.
评估前列腺癌患者接受前列腺底部与尖部的聚焦近距离放射治疗（FBT）后，其功能性尿路恢复情况是否更差。
将接受前列腺底部FBT治疗的患者的功能结局与接受前列腺尖部FBT治疗的患者的功能结局进行比较。分别在基线以及治疗后6、12和24个月，使用国际前列腺症状评分（IPSS）、国际尿失禁评分（ICS）和国际勃起功能指数（IIEF-5）问卷来测量尿路症状、尿失禁和勃起功能障碍。
分别有28例和13例患者接受了前列腺尖部和底部的FBT治疗。两组在6个月时的IPSS评分存在显著差异（平均IPSS：尖部6.4±4.7，底部10.6±5.7；p = 0.02），但在基线时以及治疗后12和24个月时无差异。多因素分析显示，仅前列腺底部的FBT仍然是尿路症状恶化的独立预测因素（比值比，5.8；p = 0.04）。
FBT治疗后6个月，接受前列腺尖部FBT治疗的患者与接受前列腺底部FBT治疗的患者相比，尿路毒性明显更低。所有患者的尿失禁和性副作用均最小。
