早期前列腺癌低剂量率近距离放射治疗10年疗效的前瞻性审计。

A prospective audit of the 10-year outcomes from low dose-rate brachytherapy for early stage prostate cancer.

作者信息

Lamb David S, Greig Lynne, Russell Grant, Nacey John N, Broome Kim, Jain Mohua, Murray Judith, Lamb Peter J, Woods Lisa

机构信息

Radiation Oncologist and Adjunct Professor, School of Biological Sciences, Victoria University, Wellington.

Chief Medical Physicist, Blood and Cancer Centre, Wellington Regional Hospital, Wellington.

出版信息

N Z Med J. 2018 Nov 9;131(1485):13-18.

PMID:30408814

Abstract

AIM

New Zealand men diagnosed with early stage prostate cancer need to know what outcomes to expect from management options.

METHODS

Between 2001 and 2016, 951 men were treated with low dose-rate brachytherapy (permanent iodine-125 seed implantation) by the Wellington Prostate Brachytherapy Group based at Southern Cross Hospital, Wellington. At follow up after treatment, men had their PSA measured and were scored for urinary, bowel and sexual side effects. RESULTS: Median follow-up of men was 7.9 years (range 2.0-16.3 years). Ten-year PSA control was 95% for the 551 men with low-risk prostate cancer and 82% for the 400 men with intermediate-risk prostate cancer. Adverse effects were generally minor and short-term only. Temporary urinary obstruction developed soon after the implant in 2.6% men, and the 10-year cumulative risk of urethral stricture was 2.6%. Erectile dysfunction developed in 29% men, two-thirds of whom had a good response to a PDE5 inhibitor. Most men returned to a normal routine within four days of the implant.

CONCLUSION

LDR brachytherapy is a highly effective low-impact treatment option for New Zealand men with early stage prostate cancer.

摘要

目的

被诊断为早期前列腺癌的新西兰男性需要了解治疗方案可能带来的结果。

方法

2001年至2016年间，惠灵顿十字医院的惠灵顿前列腺近距离治疗小组对951名男性进行了低剂量率近距离治疗（永久性碘-125粒子植入）。治疗后随访时，对男性进行前列腺特异性抗原（PSA）检测，并对泌尿、肠道和性功能方面的副作用进行评分。

结果

男性的中位随访时间为7.9年（范围2.0 - 16.3年）。551例低风险前列腺癌男性的10年PSA控制率为95%，400例中风险前列腺癌男性为82%。副作用一般较小且仅为短期。2.6%的男性在植入后不久出现暂时性尿路梗阻，尿道狭窄的10年累积风险为2.6%。29%的男性出现勃起功能障碍，其中三分之二对磷酸二酯酶5抑制剂反应良好。大多数男性在植入后四天内恢复正常生活。