Schellhammer P F, El-Mahdi A M
Urology. 1983 May;21(5):451-7. doi: 10.1016/0090-4295(83)90038-9.
Radiation complications, after definitive treatment of localized prostatic carcinoma by either external beam or interstitial implantation with Iodine-125 seeds, are reviewed. Late serious complications to immediately adjacent structures of the anterior rectal wall, prostatic urethra, bladder neck, and external sphincter occurred with similar frequency in both treatment groups. However, late serious complications of the remotely adjacent structures of the bladder, urethra, distal ureters, and circumferential rectal wall occurred more frequently in the external beam treatment series, a reflection of the fact that larger tissue volumes were irradiated. Rectal ulceration, while occurring in both treatment groups, was amenable to surgical correction or underwent spontaneous healing only in the 125I group. At this point in our experience, morbidity from late radiation complications has been less among those patients having interstitial implantation for definitive treatment of localized prostatic carcinoma.
本文回顾了采用外照射或碘 - 125粒子组织间植入对局限性前列腺癌进行根治性治疗后的放射并发症。两个治疗组中，前直肠壁、前列腺尿道、膀胱颈和外括约肌等紧邻结构发生晚期严重并发症的频率相似。然而，膀胱、尿道、远端输尿管和直肠周壁等远隔结构的晚期严重并发症在外照射治疗组中更为常见，这反映了接受照射的组织体积更大这一事实。直肠溃疡在两个治疗组中均有发生，但仅在碘 - 125粒子植入组中可通过手术矫正或自行愈合。根据我们目前的经验，对于局限性前列腺癌进行根治性治疗，接受组织间植入的患者发生晚期放射并发症的发病率较低。
