Short-term Efficacy Evaluation Of External Beam Radiotherapy Combined With Seed Implantation For High Risk Localized Prostate Cancer

Objective:To investigate the short-term efficacy and safety of external beam radiotherapy combined with seed implantation and androgen deprivation therapy for high-risk localized prostate cancer.Methods:Retrospective analysis was performed on 70 patients with highly critical prostate cancer admitted to the Cancer Center of the First Affiliated Hospital of Xinjiang Medical University from January 2019 to May 2022.On the basis of endocrine therapy,39 patients received external radiotherapy as the control group and 31 patients received external radiotherapy combined with particle implantation as the experimental group.Follow-up time was 6 months.The clinical efficacy,serum prostate-specific antigen(PSA),testosterone level and Prostate volume changes before and after treatment were compared between the two groups.The incidence of treatment-related rectal reactions,urinary symptoms,myelosuppressive reactions and sexual dysfunction were observed and recorded.Results:There was no statistical difference in the short-term efficacy between the two groups(P>0.05).The Objective Response Rate(ORR)of external radiotherapy combined with particle implantation was54.25%,and the Disease control rate(DCR)was 44.3%.The ORR and DCR of external radiotherapy group were 45.8% and 55.7% respectively.There was no significant difference in the change of prostate volume between the two groups at 3 and 6 months(P>0.05).There was a statistically significant difference in testosterone levels between the two groups at 3 months after treatment(P<0.05),that is,that is,the testosterone level of the experimental group was significantly lower than that of the control group(P<0.05).There was no significant difference between the two groups before treatment and 1 month after treatment and 6 months after treatment(P<0.05).The testosterone level in both groups was the lowest after treatment and the highest before treatment.The serum total PSA level of the two groups was statistically different at 1 month and 3 months after treatment(P<0.05),that is,the total PSA level of the two treatment time points of external radiotherapy combined with particle implantation group was significantly lower than that of external radiotherapy group.Total PSA in both groups was the lowest 6 months after treatment and the highest before treatment,and with the passage of time after treatment,total PSA in both groups showed a gradual downward trend.The proportion of total PSA≤0.2ng/ml 1 month after treatment in the external radiotherapy combined with particle implantation group(69.2%)was much higher than that in the control group(30.8%).There were no statistically significant differences in recent gastrointestinal and urinary adverse reactions,myelosuppression reactions and sexual dysfunction between the two groups(P>0.05),and no acute adverse reactions in urinary and digestive systems ≥ grade3 occurred.In the experimental group,there was 1 case of grade 3 myelosuppression reaction,and 3 cases of sexual dysfunction.Conclusions: On the basis of endocrine therapy,external radiotherapy combined with particle implantation or external radiotherapy is an effective treatment for high-risk localized prostate cancer,and acute gastrointestinal and urinary complications are acceptable.The reduction of serum total PSA level in patients with external radiotherapy combined with particle implantation was better than that in patients with external radiotherapy alone.