Crusinberry R A, Kramolowsky E V, Loening S A
Department of Urology, University of Iowa Hospitals and Clinics, Iowa City 52242.
Prostate. 1987;11(1):59-67. doi: 10.1002/pros.2990110108.
Thirty-one patients have been treated for carcinoma of the prostate with 198Au seeds placed transperineally using transrectal ultrasonic guidance. Twenty patients have been followed postoperatively for periods ranging from 3 to 31 months, with an average follow-up time of 12 months. Cumulative dose of radiation to the prostate calculated by dosimetry was either 9,000 rads or 15,000 rads. Serial transrectal ultrasound examinations performed on these patients showed a decrease in prostate size in all patients within 6 months of treatment, with a statistically significant decrease observed between the third and sixth months. No significant difference in amount or rate of tumor regression was noted when tumor stage and grade were correlated to volume decrease after treatment. Patients who received the larger doses of radiation (15,000 rads) showed a significantly greater rate of decline in prostatic volume than those who received 9,000 rads. Seven patients underwent prostate biopsy between 12 and 18 months after treatment; six biopsies showed residual tumor. Complications after treatment included urinary retention because of prostatic edema (three), radiation urethritis (three), and rectal ulceration (one). Transperineal placement of 198Au is well tolerated and offers an alternative to external beam radiation for treatment of carcinoma of the prostate.
31例前列腺癌患者经直肠超声引导经会阴植入198Au籽源进行治疗。20例患者术后随访3至31个月，平均随访时间为12个月。通过剂量测定法计算的前列腺累积辐射剂量为9000拉德或15000拉德。对这些患者进行的系列经直肠超声检查显示，所有患者在治疗后6个月内前列腺体积均减小，在第3至6个月之间观察到有统计学意义的减小。当肿瘤分期和分级与治疗后体积减小相关时，未发现肿瘤消退量或消退率有显著差异。接受较大辐射剂量（15000拉德）的患者前列腺体积下降率明显高于接受9000拉德的患者。7例患者在治疗后12至18个月接受了前列腺活检；6次活检显示有残留肿瘤。治疗后的并发症包括前列腺水肿导致的尿潴留（3例）、放射性尿道炎（3例）和直肠溃疡（1例）。经会阴植入198Au耐受性良好，为前列腺癌的治疗提供了一种替代外照射的方法。
