Prevention and treatment of rectal complications after ~(125)I brachytherapy for prostate cancer / 中国微创外科杂志

ABSTRACT

Objective To evaluate the prevention and treatment of rectal complications following 125I brachytherapy for prostate cancer. Methods A total of 90 patients with locally advanced prostate cancer was treated by transrectal ultrasound guided prostate 125I brachytherapy combined with maximal androgen blockage from November 2001 to June 2006. The patients were followed every 1～3 months postoperatively, and rectal complications was analyzed and treated. Results Eighty-nine patients were followed for 1～55 months (mean, 22 months). The incidences of rectal complications at grade Ⅰ, Ⅱ, Ⅲ, and Ⅳ were 11.2% (10/89), 6.7% (6/89), 0%, and 2.2% (2/89), respectively. Symptomatic therapy was conducted in 16 patients with grade Ⅰ or Ⅱ complications, which were symptomatically relieved 6 months later. The grade Ⅳ complications occurred in 2 patients, one of whom underwent repeated examinations and treatment for proctitis, and the other of whom was complicated with severe diabetes and received a laparocolostomy with cystostomy. Conclusions The optimal medical treatment for radiation proctitis is follow-up checkups and observations. To reduce the incidence of urethrorectal fistula, excessive examinations and treatment should be avoided. Accompanying diabetes should be treated promptly and actively.