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Transrectal Implantation of 125 Ⅰ Particles in the Treatment of Prostate Cancer

Author: LinJie
Tutor: GaoYuLi
School: Luzhou Medical College
Course: Medical Imaging and Nuclear Medicine
Keywords: Transrectal ultrasound Transrectal puncture Implanted 125I seeds Prostate cancer Endocrine therapy
CLC: R737.25
Type: Master's thesis
Year: 2011
Downloads: 35
Quote: 0
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Abstract


Objective: prostate cancer (prostate cancer, PCa) in many Western countries, is the most common malignancy in men, American men the second leading cause of cancer death in 2006. Since the early 1990s to the mid-check start using the prostate-specific antigen (PSA), found significantly higher incidence of PCa. PCa incidence in China is lower, but in recent years with the aging of the population and the improvement of living conditions, the incidence increased significantly trend, in our male urinary and reproductive system cancer incidence rate rise to third place. PCa has become especially 50-year-old men's health is an important factor affecting our men, because the PCa incidence of occult as well as our PSA test is not yet universal access to primary health care sector, so most of PCa detected already in late to clinical treatment with to the difficulties, it is how to choose the best treatment program is our common goal. In recent years, with new, low-energy, security and easy protection radionuclide 125 I development of successful real-time transrectal ultrasound precise positioning, CT imaging technology matures and computer three-dimensional stereotactic radiotherapy plan the emergence of the system, so that the treatment of various tumors radionuclides organization implantation has been extensive attention and to carry out, especially in more mature in the treatment of prostate cancer. But in the implantation of radioactive particles ways to study at home and abroad are rarely transrectal implantation has not been reported. Therefore, this research project via the rectal route implanted radioactive particles feasibility and safety of new methods and ideas for ways to provide brachytherapy for prostate cancer. Methods: In the present study, Mianyang Central Hospital from March 2006 to May 2010, 82 patients were treated with locally advanced prostate cancer patients divided into experimental and control groups. The experimental group of 42 patients with prostate cancer, prostate volume studies; treatment planning system (Treaetment Plan System, TPS) plan; using transrectal ultrasound (Transrectal Ultrasonography, TRUS) guided transrectal puncture 125 I seed implantation for prostate implementation of treatment programs, and also underwent bilateral orchiectomy treatment; postoperative CT scan three-dimensional reconstruction, the judgment of the particle distribution and assess the dose distribution, regular follow-up of patients with PSA, prostate volume and complications. Control group of 40 patients with bilateral orchiectomy. 82 cases of patients taking bicalutamide endocrine chemotherapy drugs. Results: The experimental group of 42 patients during surgery goes well, according to the original plan to complete the implanted particles 22 (10-50) teeth, no serious complications caused by transrectal puncture; postoperative use of CT scans to see the particle distribution to meet the intended plan; dose distribution assessment is satisfactory. The patients were followed up for 24-48 months, median follow-up time of 36.6 months. 1 cases 16 months after the occurrence of bone metastasis, PSA biochemical recurrence in two cases in the postoperative average of 18.6 months, the cumulative PSA progress-free survival rate of patients was 92.8%. One cases in the control group died 23 months after the operation, three cases of bone metastasis 14 months after surgery, five cases at a mean of 15.8 months PSA biochemical recurrence accumulated PSA progress-free survival rate of patients was 77.5% . Conclusions using TRUS guided transrectal the implanted 125 I radiation particle technology safe and reliable, easy to operate, effectively shortening the surgical time. Seed implantation combined with surgical castration is an effective treatment method for the treatment of locally advanced prostate cancer, should be promoted.

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CLC: > Medicine, health > Oncology > Genitourinary tumors > Male genitalia tumors > Prostate cancer
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