摘要
目的分析使用125Ⅰ粒子进行前列腺癌近距离治疗后粒子移位的发生情况及影响因素。方法 2003年12月~2010年6月共270例T1~T2期前列腺癌患者接受近距离治疗,累计植入粒子17 010粒,平均每位患者植入63粒。骨盆正位X线检查及盆腔平扫CT检查结果使用ITPS 3.2软件分析,测算靶器官实际剂量分布状况。同时记录粒子移位发生部位、前列腺体积、粒子埋植数量、术中实际使用植入针数量、前列腺包膜外粒子分布数量、是否有TURP手术史、患者PSA水平、肿瘤Gleason评分、临床肿瘤分期、术中耻骨弓遮挡情况、前列腺中叶突入膀胱情况等因素。结果 24患者出现粒子移位（24/270,8.9%）,其中21例患者出现单个粒子移位,3例患者出现2枚粒子移位。移位粒子数共27粒（27/17 010,0.16%）,其中肺部移位粒子6粒,移位至皮下或耻骨后其他区域19粒,排出体外2粒。结论术前缩小前列腺体积、减少粒子埋植总数量及包膜外粒子分布数量可减少粒子移位发生率,粒子移位无严重并发症发生。
Objective To study the incidence of seed migration after prostate cancer brachytherapy using a loose-seed（125Ⅰ） implantation technique and to identify the predictors associated with its phenomenon.Methods From December 2003 to June 2010,270 patients staging T1～T2 underwent permanent prostate brachytherapy at our hospital and were eligible for the study.Pelvic CT and chest X-rays were performed during follow-up for the quarititation and location of seeds.The patient and treatment variables potentially associated with the occurrence and number of seed migrations were analyzed.Results Incidence rate of seed migration in patient was 8.9%（24/270）,27 seeds were found migrated（0.16%,27/17 010）,among which 6 seeds migrated into thoracic cavity,19 seeds migrated into retropubic space and subcutaneous tissue,2 seeds were discharged through urine or sperm.Conclusion To decrease prostate volumn,total number of implanted seeds and extraprostatic placement of seeds can decrease the frequency of seed migration.With history of TURP and hyperplasia of middle lope of prostate are associated with an increased frequency of seed migration.A small proportion of migrated seeds will not effect the dosimetry of target organ of prostate.No severe complications was observed in cases of seeds migration.
出处
《基础医学与临床》
CSCD
北大核心
2011年第5期570-573,共4页
Basic and Clinical Medicine
