저위험군 및 중간위험군 국소 전립선암의 저선량 근접치료
Low-Dose-Rate Brachytherapy for Low- and Intermediate-Risk Groups of Localized Prostate Cancer
박동수, 오종진, 장웅기, 지상현, 신현수,
소속 상세정보
박동수 ( Park Dong-Soo )
CHA의과학대학교 분당차병원 비뇨기과학교실
오종진 ( Oh Jong-Jin )
CHA의과학대학교 분당차병원 비뇨기과학교실
장웅기 ( Jang Woong-Ki )
CHA의과학대학교 분당차병원 비뇨기과학교실
지상현 ( Jee Sang-Hyun )
CHA의과학대학교 분당차병원 비뇨기과학교실
신현수 ( Shin Hyun-Soo )
CHA의과학대학교 분당차병원 방사선종양학교실
KMID : 0358320090500070656
Abstract
Purpose: We applied low-dose-rate brachytherapy for low- and intermediate-risk groups of prostate cancer patients. Our initial experiences were analyzed to assess the result of low-dose-rate brachytherapy for low- and intermediate-risk groups of patients with localized prostate cancer.
Materials and Methods: A total of 50 consecutive patients have been treated with brachytherapy for 1 year since April 2007. Among them, a total of 24 patients in the low- or intermediate-risk groups were enrolled: 10 of the 24 patients were in the low-risk group (clinical T1a-T2b, Gleason score [GS] of 2-6, PSA＜10 ng/ml), and 14 patients were in the intermediate-risk group (clinical T2b-T2c, Gleason score of 7, or PSA 10-20 ng/ml). Implantations were performed by practicing a real-time ultrasound-guided placement including prostatic capsular placement in the intermediate-risk group. All 24 patients were treated with 1 to 3 months of androgen-deprivation therapy.
Results: In the low- and intermediate-risk groups, the median patients’ ages were 64 and 70 years, respectively. The numbers of patients in the low-risk group according to clinical T stage were 4 cases of T1c and 6 cases of T2a. The intermediate-risk group included 4 patients of stage T2a, 3 patients of stage T2b, and 7 patients of T2c. Five patients with a GS≤6 and 9 patients with a GS of 7 were classified as being in the intermediate-risk group. Serum PSA levels in the intermediate-risk group were less than 10 ng/ml in 11 patients and 10-20 ng/ml in 3 patients. The median radiation doses delivered to 90% of the prostate in the low-risk and intermediate-risk groups were 257.5 Gy (range, 142.5-357.5 Gy) and 260.0 Gy (range, 147.5-357.5 Gy), respectively. Biochemical failure was not revealed in any case during follow-up. No patients experienced major complications.
Conclusions: We can expect outstanding local control effect with low-dose-rate brachytherapy in low- and intermediate-risk prostate cancer. Our technique of modifying the insertion field in the intermediate-risk group is feasible and tolerable. However, long-term follow-up data are needed for this strategy.
키워드
Prostate; Cancer; Brachytherapy; Risk
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