In recent years, the incidence of prostate cancer is increasing year by year, which has become a threat to the health of male reproductive system of the main diseases, Brachytherapy for the treatment of prostate cancer is a form of treatment for prostate cancer, and is widely used in the treatment of prostate cancer. Near distance treatment is the use of special equipment, under the guidance of CT or B ultrasound, through a special guidance system will be directly put into the prostate, radioactive radionuclides continue to release radiation to kill the tumor cells. Compared with radical prostatectomy and external radiation therapy (EBRT), brachytherapy has the same biochemical control rate, and complications are more likely to be accepted by patients. There was no significant difference in the 5-year survival rates between brachytherapy and radical prostatectomy [1]. As a form of radiation therapy, the complications and the quality of life of patients, and the patient’s tolerance degree have obvious advantages, therefore, more and more attention has been paid to brachytherapy. From March 2006 to May 2013, our hospital used ¹²⁵I radioactive seed implantation in the treatment of 30 cases of prostate cancer in the second phase, and 32 patients with prostate cancer underwent radical surgery during the same period as a control study. Each patient who participated in the clinical study signed a declaration of voluntary participation in the clinical study, the study was also approved by the hospital ethics committee in order to evaluate the effect of the treatment. Now the report is as follows.

Prostate cancer is the second most common cancer in the United States. The average annual incidence increased by 8%. Prostate cancer research abroad is very wide, more than 26,000 people in the United States each year to receive radiation therapy. The application of Perineal ultrasound-guided particle implantation in the treatment of prostate cancer is very rapid, and has become one of the standard treatments for early prostate cancer. In recent years, with the change of living environment, diet structure and life style, the incidence of prostate cancer in China has increased year by year, but we still have a great gap with foreign countries in this field. It was not until 2001 that our country was the first to complete the first ¹²⁵I of the interstitial brachytherapy for prostate cancer. In recent years, the perineal template and TRUS guided percutaneous implantation of particles, positioning accuracy, good reproducibility, and has been widely used. However, the pathway to by puncture, in the larger prostatic (equal to or more than 60 ml) or pubic arch is too narrow, the puncture path susceptible to pubic

*P < 0.01.

*P < 0.01.

arch partial occlusions caused prostate seed leakage graft and implant location offset [4], To the middle of the larger easily urethral injury. With middle leaf protruding into the bladder to easily penetrate into the bladder, cause urethral, bladder injury bleeding and particle typographical error [5] [6], these are ABS as a relative contraindication [2]. TRUS guided by the rectal route, the Department of the Department by the forward puncture, to avoid the perineal approach to these aspects of the problem [5] [6]. Operation will not be affected by the pubic arch interference, not easy to hurt the bladder and ureter, the middle of the puncture is not affected by the urethra. No anesthesia was used in the operation of the rectal route and no severe pain. The patients were treated with the ¹²⁵I radioactive seed implantation comparison of visible with open surgery and the way of perineal puncture. Rectal prostate ¹²⁵I radioactive seed implantation treatment and the use of radical surgery for prostate cancer compared to the operation is more simple and fast, the treatment group ¹²⁵I radioactive particles by rectal implantation average of 60 min minutes or so, far less than the operation of the control group. The amount of blood loss, postoperative hospital stay, blood transfusion and hospitalization expenses were less than that of prostate cancer radical operation group by the rectum ultrasound-guided ¹²⁵I radioactive particles. The patients’ satisfaction rate was higher than that in the radical operation group. No serious complications were caused by rectal puncture. On the comparison of major postoperative complications, the incidence of urinary retention in the treatment group was higher than that of the control group (P < 0.01), analysis of the causes and the anterior prostate volume, increase in the middle lobe, IPSS score, the number of puncture needles, the number of implanted particles (P < 0.01), and age, clinical stage, preoperative Gleason score, PSA independent (P all > 0.05). Ohashi [7] Toshio’s study suggests that even after a radioactive dose of tissue is small, there is still an acute retention of urine, so that the cause of retention of urine is not the amount of radioactive material, but the damage to the prostate tissue caused by the implantation of the particles. IPSS is the international prostate symptom score, the higher the number of symptoms of difficulty in urination, the higher the value of the score, the more obvious symptoms of the relative difficulty of urination after implantation, the greater the possibility of acute urinary retention. According to our study, the number of puncture needles and the IPSS score of the implanted particles can be used as a predictive factor for the occurrence of acute urinary retention [8]. Erectile dysfunction (ED) and urinary incontinence in the treatment group were significantly lower than that of the prostate cancer radical operation group after the operation. ED after prostate brachytherapy (PB) is not very clear, but some studies have indicated that ED may be related to the injury of the puncture needle after treatment; After treatment in the long-term process of ED may with the local short distance radiotherapy induced vascular injury, the bulb of penis nerve damage (to reduce the number of neural nitric oxide synthase), thus on penile corpus cavernosum smooth muscle function caused by damage [9]. In the comparison of curative effect after operation in the two groups. After rectal radioactive ¹²⁵I seeds implantation in the treatment group, 2 cases of patients after 6 months appear PSA is apparently elevatory, systemic examination found bone metastases, underwent endocrine therapy are still alive. Prostate cancer radical surgery group also has 2 cases of patients with PSA significantly increased 5 months after surgery, systemic examination did not find bone metastases, and the external irradiation plus endocrine therapy. Cumulative PSA progression free survival rate was 93.3% (compared with control group P > 0.05) in the patients who were treated by rectal radioactive ¹²⁵I seed implantation. Prostate cancer radical surgery group cumulative PSA progression free survival rate was 93.7%. For patients with stage II prostate cancer, the treatment of prostate cancer by ¹²⁵I particles with a diameter of the rectum compared with the radical operation of prostate cancer, the clinical effect is equivalent (P > 0.05).

To Summarize our research results, TRUS guided percutaneous prostate ¹²⁵I particle implantation puncture complications less, the use of rectal two-dimensional ultrasound and TPS in the development of real-time treatment plan, can accurately reconstruct the three-dimensional shape of the prostate. Design the implantation path, location and quantity of particles to achieve three-dimensional conformal radiotherapy. And the method of the surrounding tissue injury is small, the operation is simple and rapid, safe and feasible, the treatment cost is relatively low, postoperative recovery is fast, no serious complications can improve the survival rate of patients, and contribute to the control of tumors in this type of patients, it is worth clinical application.

China Sichuan provincial health department scientific research project fund (number 070202).

The authors declare no conflicts of interest regarding the publication of this paper.

Xin, Y.P., Guo, D.L., Qi, J.G., Chen, Z.G., Shao, H.G. and Yuan, G.Y. (2020) Prospective Clinical Study of ¹²⁵I Particle Permanent Implantation for Prostate Cancer. Open Journal of Urology, 10, 52-59. https://doi.org/10.4236/oju.2020.103007