125 I Seed Implantation Combined with Maximum Androgen Blockade in the Treatment of High Risk Prostate Cancer
ZHANG Chun-ting,XU Min,ZHU Sheng-sheng
Department of Urology, Jinhua People' s Hospital, Jinhua (321000), China
Abstract:
Objective To investigate the clinical effect of 125I radioactive seed implantation combined with maximum androgen blockade in the treatment of high-risk prostate cancer. Methods Seventy-eight patients with high risk prostate cancer were implanted the 125 I radioactive particles through the perineum under general anesthesia, and under lithotomy, to outline the prostate through transrectal ultrasound, to make the implantation plan by computer, then the endocrine therapy was stopped after 18 months of total androgen blockade, and PSA was tested every three months. PSA was increased by more than 2 ng / mL or two times original threshold for three times, then secretory therapy was resored. Results The operation of all patients was successful, 41—94 particles were implanted, with an average of 69 particles. The patients were followed up for 18—54 months, with an average of 35 months. After 18 months of endocrine therapy, PSA value of 56 patients decreased to less than 0.02 ng/mL, PSA vslue of 18 patients were less than 0.02 ng/mL, PSA value of four patients were rebound; one patient died of multiple bone metastases after 27 months of surgery; three patients had PSA rebound after 39 months of surgery, and they were treated use total androgen block endocrine therapy after 3 months, PSA was decreased to the low value at the time of treatment. At present, PSA value of 53 patients was less than 0.02 ng / mL during followed-up, and they were continued to be monitoring PSA and general condition. Conclusion 125 I seed implantation combined with total androgen blockade is a minimally invasive and effective method for the treatment of high-risk prostate cancer.
