前列腺癌近距离治疗的效果和不良反应分析  

Analysis of efficacy and adverse events of brachytherapy for prostate cancer

作　　者：王天昱[1,2] 陈晓鹏[1,2] 李学松[1,2] 陈翔[1,2] 宋刚[1,2] 蔡林[1,2] 何志嵩[1,2] 周利群[1,2] 郭应禄[1,2] 

机构地区：[1]北京大学第一医院泌尿外科 [2]北京大学泌尿外科研究所国家泌尿男生殖系肿瘤研究中心,北京100034

出　　处：《现代泌尿外科杂志》2013年第4期322-328,共7页Journal of Modern Urology

摘　　要：目的探讨局限性前列腺癌患者接受近距离治疗的疗效及不良反应。方法 2001～2010年接受近距离治疗的局限性前列腺癌患者67例。随访术后PSA变化及不良反应发生情况,并分析影响治疗效果的相关因素。结果 64例(95.5%)获得平均33.9(4～112)个月的随访。术前PSA平均为20.04ng/mL,术后最低PSA值平均为1.15ng/mL,40例(62.5%)患者最低PSA值<1ng/mL,26例(40.6%)患者最低PSA值<0.5ng/mL,达最低PSA值时间平均为术后11(1～26)个月。术后常见短期不良反应有:发热4例,血尿8例,便血3例。长期不良反应有:尿路刺激症状19例,便血7例,血尿2例,尿失禁2例,尿潴留1例。结论近距离治疗是局限性前列腺癌的有效治疗方法,疗效肯定,并发症发生率低,严重不良反应少见。Objective To investigate the efficacy and adverse effects of brachytherapy for patients with prostate cancer. Methods During 2001 to 2010, 67 patients with prostate cancer received brachytherapy and were followed up for PSA and adverse effects. The relative factors which might affect the efficacy of brachytherapy were analyzed. Results A total of 64 patients （95.5 % ） were followed up for an average of 33.9 （4 ～ 112）months. The preoperative PSA and nadir postoperative PSA were 20.04 ng/mL and 1.15 ng/mL in average, respectively. The nadir PSAs of 40 patients （62.5%） were less than 1 ng/mL, and those of 26 patients （40.6%） were less than 0. 5 ng/mL. The average time to reach the nadir PSAs was 11（ranging 1～26） months after operation. Common short-term postoperative adverse events included： fever in 4 patients, hematuria in 8 pa- tients, and hematochezia in 3 patients. Long-term postoperative adverse events included： irritation in 19 patients, hematoche- zia in 7 patients, hematuria in 2 patients, incontinence in 2 patients, and urinary retention in 1 patient. Conclusion Brachy- therapy is an effective method to treat localized prostate cancer, with relatively low rate of complications and rare occurrence of severe adverse events.

关 键 词：前列腺癌 近距离治疗 前列腺特异性抗原 

分 类 号：R737.25[医药卫生—肿瘤]