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[目的]探讨应用间歇内分泌治疗(IHT)联合125I放射粒子植入近距离放疗治疗T3期前列腺癌的治疗效果。[方法]临床分期为T3期前列腺癌16例,间歇内分泌治疗为药物去势联合抗雄激素治疗的全雄性激素阻断治疗,治疗时限选择为125I放射粒子植入近距离放疗前3个月加近距离放疗后6个月,以后根据每月前列腺特异抗原(PSA)的检测结果决定是否进行内分泌治疗,如果PSA持续升高,就再次启用内分泌治疗。近距离放疗是通过计算机三维治疗计划系统,经直肠超声引导将125I粒子均匀植入前列腺内。[结果]16例病人手术均顺利完成,未发生出血,感染等并发症。术后随访20～42个月,平均31个月。16例患者术后6个月后血清PSA均降至正常,前列腺体积明显缩小。其中2例患者术后26个月PSA持续上升,经内分泌治疗3个月后1例下降至正常范围,1例恶化发生骨转移,PSA无进展生存率93.75%。[结论]间歇内分泌治疗联合125I放射性粒子植入是T3期前列腺癌综合治疗的有效手段。
[Objective] To investigate the therapeutic effect of intermittent endocrine therapy (IHT) combined with 125I radioactive particle implantation brachytherapy on stage T3 prostate cancer. [Method] The clinical stage was T3 in 16 cases of prostate cancer, intermittent endocrine therapy for the castration combined with anti-androgen therapy androgen blockade therapy, the treatment of choice for 125I radioactive particle implantation brachytherapy before 3 months After 6 months of brachytherapy, the endocrine therapy is decided on the basis of the monthly prostate specific antigen (PSA) test results. If the PSA continues to increase, endocrine therapy is again enabled. Brachytherapy is through the computer three-dimensional treatment planning system, guided by the rectal ultrasound 125I particles uniformly implanted in the prostate. [Results] The operation of 16 patients was successfully completed, no complications such as bleeding and infection occurred. The patients were followed up for 20-42 months with an average of 31 months. Sixteen patients after 6 months after the serum PSA were normal, the prostate volume was significantly reduced. PSA in 2 patients continued to increase at 26 months after operation, and one case fell to the normal range after 3 months of endocrine therapy. One case had bone metastasis and the progression-free survival rate of PSA was 93.75%. [Conclusion] Intermittent endocrine therapy combined with 125I radioactive seed implantation is an effective method for comprehensive treatment of T3 prostate cancer.