Clinical Efficacy Of Iodine 125 Seed Implantation Combined With Endocrine Therapy In The Treatment Of Metastatic Prostate Cancer

Objective:The clinical efficacy of iodine 125 seed implantation combined with endocrine therapy in the treatment of metastatic prostate cancer was retrospectively analyzed.Methods:The clinical data of 40 patients with metastatic prostate cancer treated in Yunnan Cancer Hospital from May 2007 to May 2018 were retrospectively analyzed.On the basis of endocrine therapy,20 patients who received iodine 125 seeds implantation were included in the observation group,and 20 patients who received systemic chemotherapy(10 patients,chemotherapy group)or external radiotherapy(10 patients,external radiotherapy group)were included in the control group.The patients in the two groups were reviewed regularly after treatment,and the prostatic specific antigen(PSA),the prostate volume and the quality of life(KPS)scores were dynamically monitored.The minimum PSA level and the time required to reach the minimum level,the Progression-free survival(PFS),the 3-year and 5-year overall survival rate(OS)were recorded.Results:After treatment,the PSA decreased,the prostate volume decreased and the KPS scores increased in the observation group,the control group,the chemotherapy group and the external radiotherapy group.The PSA and the KPS scores of each group decreased significantly within 4 years after treatment compared with those before treatment(P<0.05);but there was no significant difference in 5 years after treatment compared with those before treatment(P>0.05).The volume of prostate in each group within 5 years after treatment was significantly different from that before treatment(P<0.05);There were no significant difference in PSA,prostate volume and KPS score between the observation group and the other three groups at different stages of treatment(P>0.05).The minimum PSA level of the observation group was similar to that of the control group,the chemotherapy group and the external radiotherapy group:[(5.14±9.98)ug/L(1.33 ± 2.29)ug/L,P=0.64]?[(5.14±9.98)ug/L VS(1.69±3.08)ug/L,P=0.307]?[(5.14±9.98)ug/L VS 0.97±1.12)ug/L,P=0.812].The time required to reach the minimum PSA level of the observation group was similar to that of the other three groups,too:[(10.8±6.7)mon VS(13.2±8.4)mon,P=0.398]?[(10.8±6.7)mon VS(8.7±3.3)mon.P=0.619]?[(10.8±6.7)mon VS(17.7±9.64)mon,P=0.055].The PFS ofthe observation group was similar to that of the other three groups:[(21.55±18.019)mon VS(21.6±12.258)mon,P=0.355]?[(21.55±18.019)monra(18.3±8.99)mon,P=0.812]?[(21.55±18.019)mon VS(24.9± 14.56)mon,P=0.198].The Kaplan-Meier survival curve also showed that there was no significant difference in PFS among different groups(P>0.05).In this study,The Kaplan-Meier survival curve showed that OS in the observation group was significantly higher than that in other groups(P<0.05).Conclusion(s):Iodine 125 seed implantation combined with endocrine therapy in the treatment of metastatic prostate cancer can achieve a certain effect.Its effect is similar to that of systemic chemotherapy or external radiotherapy combined with endocrine therapy.And the 3-year and 5-year OS were significantly superior to the other two treatments.This treatment is one of the options for the patients who with metastatic prostate cancer.