Schellhammer P F, el-Mahdi A E, Ladaga L E, Schultheiss T
J Urol. 1985 Dec;134(6):1140-5. doi: 10.1016/s0022-5347(17)47660-9.
Interstitial implantation with the 125iodine isotope has been used as definitive treatment in 115 patients with localized carcinoma of the prostate. The disease was staged surgically by bilateral pelvic lymphadenectomy in all of the patients. Followup has been for a minimum of 1 year and 64 patients have been followed for a minimum of 5 years. There has been no operative mortality in this series. Mean patient age at implantation was 63 years. Potency has been maintained in 31 of 46 patients (78 per cent) followed for a minimum of 5 years and 15 of 26 (58 per cent) followed for a minimum of 7 years. At 5 years the actuarial survival free of disease by surgical stage was 100, 81, 49 and 41 per cent for patients with stages A2, B, C and D1 disease, respectively. All 7 patients with stage B1 nodules followed to 5 years are free of disease. The actuarial survival free of disease by grade at 5 years was 95 per cent for patients with well, 65 per cent with moderately and 34 per cent with poorly differentiated tumors. Local failure was defined as palpable evidence of prostatic enlargement or irregularity with biopsy confirmation of neoplasm. Patients with positive biopsy plus normal or stable prostatic examinations were not considered local failures, although such patients are at high risk for failure in the future. The actuarial probability of local failure at 5 years was 0, 13, 27 and 44 per cent for patients with surgical stages A2, B, C and D1 disease, respectively, and 5, 23 and 43 per cent for those with well, moderately and poorly differentiated tumors, respectively. Based on our experience, interstitial implantation with 125iodine isotope is reserved for patients with well or moderately differentiated stage B lesions. The ultimate success of this treatment modality awaits 10 and 15 years of followup.
125碘同位素间质植入术已被用于115例局限性前列腺癌患者的确定性治疗。所有患者均通过双侧盆腔淋巴结清扫术进行手术分期。随访时间至少为1年，64例患者随访时间至少为5年。该系列中无手术死亡病例。植入时患者的平均年龄为63岁。46例随访至少5年的患者中有31例（78%）维持了性功能，26例随访至少7年的患者中有15例（58%）维持了性功能。5年时，A2、B、C和D1期疾病患者按手术分期的无病精算生存率分别为100%、81%、49%和41%。所有7例随访至5年的B1期结节患者均无病。5年时，高分化、中分化和低分化肿瘤患者按分级的无病精算生存率分别为95%、65%和34%。局部失败定义为可触及前列腺肿大或不规则，并经活检证实为肿瘤。活检阳性但前列腺检查正常或稳定的患者不被视为局部失败，尽管这些患者未来发生失败的风险很高。5年时，手术分期为A2、B、C和D1期疾病的患者局部失败的精算概率分别为0%、13%、27%和44%，高分化、中分化和低分化肿瘤患者的局部失败精算概率分别为5%、23%和43%。根据我们的经验，125碘同位素间质植入术适用于高分化或中分化的B期病变患者。这种治疗方式的最终成功有待10年和15年的随访结果。
