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低剂量率近距离放射疗法作为局限性前列腺癌的微创根治性治疗方法,具有出色的肿瘤学和功能学结果:一项单中心回顾性分析

Low-dose-rate brachytherapy as a minimally invasive curative treatment for localised prostate cancer has excellent oncological and functional outcomes: a retrospective analysis from a single centre.

作者信息

D'hulst Pieter, Mattelaer Pieter, Darras Jochen, Staelens Lorenzo, Pottel Hans, Ponette Diederik

机构信息

Az Damiaan Oostende, Department of Urology, Oostende, Belgium.

AZ Delta Roeselare, Department of Radiation Oncology, Roeselare, Belgium.

出版信息

Cent European J Urol. 2018;71(3):270-275. doi: 10.5173/ceju.2018.1749. Epub 2018 Sep 22.

DOI:10.5173/ceju.2018.1749
PMID:30386646
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6202624/
Abstract

INTRODUCTION

Low-dose-rate (LDR) brachytherapy is a widely used therapeutic option for localised prostate cancer. The aim of this study was to analyse the oncological and functional outcomes after 10 years of experience with brachytherapy for localised prostate cancer.

MATERIAL AND METHODS

All patients who underwent brachytherapy between April 2006 and September 2017 were included for analysis. Initial prostate-specific antigen (PSA) levels, tumour stages, Gleason scores, positive biopsies, prostate volumes, dosimetric parameters, and urinary symptoms were noted.

RESULTS

A total of 201 patients underwent brachytherapy between April 2006 and September 2017. Of these patients, 159 had >3 years of oncological and functional follow-up. Only these relevant patients were included in the statistical analysis. This showed a significant, persistent decline in PSA levels (p <0.0001): the mean PSA was 1.2 ng/ml after 6 months, 1.1 ng/ml after 1 year, and 0.49 ng/ml after 3 years. Only 9 patients had tumour recurrence (3 patients with Gleason score 6 and 6 patients with Gleason score 7). After receiving adequate treatment, the patients underwent oncological follow-up.Important obstructive and irritative complaints were most pronounced during the first 9 months and decreased strongly after 18 months of follow-up.

CONCLUSIONS

LDR brachytherapy has excellent oncological outcomes with limited functional inconveniences that are adequately treatable. Our 10 years' experience shows that brachytherapy is a safe and effective method for the treatment of low-risk localised prostate cancer.

摘要

引言

低剂量率(LDR)近距离放射治疗是局部前列腺癌广泛应用的一种治疗选择。本研究的目的是分析局部前列腺癌近距离放射治疗10年经验后的肿瘤学和功能结局。

材料与方法

纳入2006年4月至2017年9月期间接受近距离放射治疗的所有患者进行分析。记录初始前列腺特异性抗原(PSA)水平、肿瘤分期、 Gleason评分、阳性活检结果、前列腺体积、剂量学参数和泌尿系统症状。

结果

2006年4月至2017年9月期间共有201例患者接受了近距离放射治疗。其中,159例患者有超过3年的肿瘤学和功能随访。仅这些相关患者纳入统计分析。结果显示PSA水平显著持续下降(p<0.0001):6个月时平均PSA为1.2 ng/ml,1年时为1.1 ng/ml,3年时为0.49 ng/ml。仅9例患者出现肿瘤复发(3例Gleason评分为6分,6例Gleason评分为7分)。接受适当治疗后,患者进行肿瘤学随访。重要的梗阻性和刺激性症状在最初9个月最为明显,随访18个月后显著减轻。

结论

LDR近距离放射治疗具有良好的肿瘤学结局,功能不便有限且可得到充分治疗。我们10年的经验表明,近距离放射治疗是治疗低风险局部前列腺癌的一种安全有效的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc88/6202624/5a54d6690d33/CEJU-71-1749-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc88/6202624/6f4605f03a08/CEJU-71-1749-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc88/6202624/5a54d6690d33/CEJU-71-1749-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc88/6202624/6f4605f03a08/CEJU-71-1749-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc88/6202624/5a54d6690d33/CEJU-71-1749-g002.jpg

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