放射性125I粒子植入联合内分泌治疗早期前列腺癌

目的:探讨经会阴超声引导放射性125I粒子植入联合去势治疗早期前列腺癌疗效和不良反应.方法: 39例早期前列腺癌实施经会阴超声引导和适时计划指导放射性125I粒子植入治疗,7例粒子术前行去势术,21例粒子植入后同时行去势术,11例粒子治疗后联合药物去势治疗.粒子治疗的匹配周边剂量(matched peripheral doses,MPD)为145-160Gy,尿道剂量低于400Gy.125I粒子活度0.35-0.50mCi,中位植入69颗(19-97颗).结果: 失败标准为前列腺特异抗原(prostate specific antigen,PSA)治疗后升高>4ng/ml,≤4ng/ml为生物化学无进展生存(biochemical disease-free survival,BDFS).全部患者顺利完成粒子植入术.36例粒子治疗后达到BDFS,3例分别在粒子治疗后6、8和36个月PSA升高,2例行内分泌治疗,1例行外放疗联合内分泌治疗.2年和3年BDFS分别为94.8%(37/39)和92.3%(36/39).粒子植入治疗后Ⅰ级和Ⅱ级直肠不良反应发生率分别为5.1%(2/39)和7.7%(3/39),没有Ⅲ级和Ⅳ级直肠反应.粒子植入治疗后Ⅰ级、Ⅱ级和Ⅲ级尿道不良反应发生率分别为53.8%(20/39)、17.9%(7/39)和2.6%(1/39),对症处理好转.2例粒子移位,没有相关并发症.结论: 经会阴超声引导放射性125I粒子植入治疗前列腺癌具有安全、微创、并发症发生率低等优点.     

超声引导^125I粒子植入治疗前列腺癌方法的建立与近期疗效

目的探讨超声引导放射性^125I粒子治疗前列腺癌方法建立和近期疗效。方法26例前列腺癌全身或硬膜外麻醉下行经直肠超声引导粒子植入治疗。经直肠超声获取前列腺图像,将图像直接传输到计算机治疗计划系统,术中适时计算机计划,肿瘤周边匹配剂量（matched peripheral doses,MPD）145～160Gy。根据治疗计划插植粒子针,利用Mick植入器植入粒子,粒子植入总数为19—90颗,粒子活度0．35～0．4mCi。术后1个月行盆腔CT扫描,质量验证。结果26例患者成功实施会阴超声和模板引导放射性^125I粒子组织间近距离治疗前列腺癌手术。手术历时1—1．5h。术后验MPD为（137．73±36．5014）Gy。26例前列腺癌患者^125I粒子治疗后生物化学控制率92．3％,2例患者术后6个月出现骨转移。^125I粒子植入治疗,34．6％无尿道副反应,Ⅰ、Ⅱ、Ⅲ、Ⅳ和Ⅴ级尿道副反应分别为38．5％、11．5％、11．5％、0和0。Ⅰ级直肠副反应发生率为3．9％。1例患者1颗粒子移位,没有引起临床相关并发症,无粒子移位到肺。结论经会阴超声引导放射性粒子治疗前列腺癌具有微创、精确度高和副反应发生率低等优势。     

辅助内分泌治疗配合放射性粒子组织间植入治疗局限性前列腺癌

 目的 探讨辅助内分泌治疗配合放射性粒子组织间植入治疗局限性前列腺癌的安全性和有效性。方法 22例T1 ~ T2c前列腺癌患者在采用直肠超声引导经会阴穿刺放射性125I粒子组织间植入治疗前后，给予辅助内分泌治疗4 ~ 7个月。术前2 ~ 4个月，术后1 ~ 4个月。结果 22例手术均顺利完成，手术时间60 ~ 120 min，植入125I粒子40 ~ 75枚，术后随访12 ~ 48个月，前列腺特异性抗原（PSA）＜1 ng／ml 15例，1 ng／ml≤PSA＜2 ng／ml 2例，PSA≥2 ng／ml 5例。结论 辅助内分泌治疗配合放射性粒子组织间植入治疗局限性前列腺癌安全有效     

放射性 125 I粒子植入治疗睾丸切除术后复发性前列腺癌

目的探讨超声引导放射性 125 I粒子植入治疗复发前列腺癌.方法8例前列腺癌去势术后复发实施超声引导放射性 125 I粒子植入治疗.2例单纯粒子植入治疗,肿瘤匹配周边剂量为(matched peripheral dose,MPD)90～145 Gy,2例先行外放疗,外放疗剂量为40～45 Gy.粒子活度0.35～0.40 mCi.随访3～29个月,连续3次前列腺特异抗原(prostate specific antigen,PSA)升高即为生物化学失败(biochemical failure).结果粒子治疗前后PSA分别为(7.53±7.64)ng/mL 和(1.25±1.19)ng/mL,统计学处理明显下降,t=2.297,P=0.038.2例生物化学失败,生物化学控制率(biochemical control rate)为6/8例,1例出现1级泌尿道并发症,1例出现2级泌尿道并发症.1/8例患者粒子发生移位,但是并没有引起临床相关并发症,没有粒子移位到肺.结论超声引导经会阴放射性 125 I粒子植入治疗复发前列腺癌具有安全、微创、并发症发生率低和疗效肯定,是一种较理想的补救治疗手段.     

联合间歇性内分泌与^125Ⅰ放射性粒子植入术治疗局部晚期前列腺癌（附20例报告）

目的：探讨联合^125Ⅰ放射性粒子植入术和间歇性内分泌治疗局部进展期前列腺癌的临床价值。方法：前列腺癌患者20例,年龄52～80岁,中位年龄74岁,PSA：6．83～643．8ng／mL,Gleason Score：7～9分,临床分期T3NOMO.连续硬膜外麻醉,截石位,直肠超声从前列腺基底到尖部进行扫描,图像传送至计算机计划系统进行三维重建和术中计划,根据计划行直肠超声引导下经会阴^125Ⅰ放射性粒子植入术,术后结合雄激素全阻断疗法。当PSA达到0ng／mL,并稳定2个月后停止内分泌治疗,当PSA连续3次上升,则重新开始内分泌治疗。结果：所有患者手术均顺利,术中使用穿刺针26～36根,植入粒子57～99粒,平均73粒。术后随访8～51个月,平均22月。1例术后16个月发生骨转移,1例术后22个月死亡。术后3～5个月所有患者的PSA都降到正常范围,其中3例PSA未达到0ng／mL,未停药。4例术后5～26个月,出现PSA反弹,再次用药3～5个月PSA值达到0ng／mL。目前12例未出现PSA反弹,第一周期脱离治疗时间2～44个月,平均16．9个月。近期出现的并发症有轻至中度尿路刺激症30％（6／20）,急性尿潴留5％（1／20）,直肠刺激症和血便25％（5／20）,多数患者症状随访1年后缓解。目前18例患者的PSA值在0～1．2ng/mL之间,其中17患者PSA≤0．17ng／mL。结论：对于局部晚期前列腺癌,^125Ⅰ放射粒子植入术结合间歇性内分泌是一种安全有效的治疗方法。     

肝动脉化疗栓塞分别联合经皮微波凝固治疗与^125I放射性粒子植入治疗原发性大肝癌的疗效观察

目的评价和比较肝动脉化疗栓塞（TACE）联合经皮微波凝固治疗（PMCT）与TACE联合^125I放射性粒子植入治疗原发性大肝癌的效果。方法46例原发性大肝癌患者接受TACE联合PMCT治疗,20例接受TACE联合^125I放射性粒子植入治疗。术后2个月、3个月分别行动态增强CT复查。观察并比较两组疗效、毒副反应及并发症发生的情况。结果综合治疗后3个月,TACE联合PMCT组的有效率为82．61％,明显高于TACE联合^125I放射性粒子植入组的有效率55．00％（P〈0．05）。两组的临床总控制率分别为93．47％、85．00％（P〉0．05）。两组发生的毒副反应无明显差异,均未出现严重并发症。结论TACE联合PMCT及TACE联合^125I放射性粒子植入均为原发性大肝癌安全、有效的治疗方法,两组毒副反应及并发症的发生率相当,前者治疗效果较为理想,值得临床应用。     

CT引导下经皮穿刺植入^125I粒子治疗老年中心型肺癌近期疗效分析

目的：探讨CT引导下经皮穿刺组织问植入^125I粒子治疗老年中心型肺癌的近期疗效。方法：30例老年中心型肺癌（鳞状细胞癌），随机分成A、B两组，A组为^125I粒子治疗组（15例），采用经皮穿刺组织间^125I粒子植入术，^125I粒子放射性活度为0．8mCi／颗，据TPS计划系统确定粒子放射性总活度和布源。B组为对照组（15例），采用经支气管动脉化疗药物灌注术，灌注的化疗药物为环磷酰胺、多柔比星及顺铂。结果：A组总有效率86．67％，B组总有效率53．33％，二者比较差异有统计学意义，P〈0．05。A组病例治疗后新发生椎体（T12）转移1例；B组病例治疗后新发生纵隔淋巴结转移1例，脑转移1例。结论：经皮穿刺组织间植入^125I放射微粒子治疗老年中心型肺癌（鳞状细胞癌）近期疗效显著，优于单纯经支气管动脉化疗药物灌注术。     

转移及复发性骨肿瘤的放射性125I粒子植入治疗初探

目的探讨放射性^125I粒子组织间种植治疗转移及复发性骨肿瘤的技术方法和疗效。方法对14例转移及复发性骨肿瘤患者行肿瘤内^125I粒子植入治疗，粒子植入数目为3～145颗，粒子活度为18．5～29．6MBq（0．5～0．8mCi），肿瘤匹配周边剂量为115～145Gy。术后行质量验证并观察患者临床指标改善情况。结果随访7～29个月（平均12．4个月）。^125I粒子治疗90％肿瘤靶体积接受的最小剂量（D90）中位值为108．12Gy（27～166Gy），10例脊柱或椎旁肿瘤患者脊髓的中位D90为31．9Gy（6．2～74．0Gy）。粒子植入前伴有疼痛的12例患者，术后疼痛完全缓解率达82％，止痛有效率为92％。10例脊柱或椎旁肿瘤患者中，70％的患者疗后行走能力改善或恢复正常。1年局部控制率为82％，1年生存率为53％，围手术期无3级以上严重并发症发生。结论放射性^125I粒子植入安全、高效，是治疗转移及复发性骨肿瘤的一种有前途的新方法。     

^125I组织问放疗联合介入治疗肝癌42例报告

目的探讨^125I放射性粒子组织间放疗联合肝动脉介入治疗肝肿瘤的疗效、可行性和安全性。方法2005年2月至2008年2月,对42例肝癌住院患者实施了放射性粒子^125I组织间放疗联合肝动脉介入治疗。其中肝细胞癌38例,胆管癌4例。病例均经CT、超声、MRI检查或病理穿刺活检证实。全部病灶在接受肝动脉介入治疗2周内,在CT、超声导向下将^125I放射性粒子植入肿瘤碘油栓塞区内及其周围,随之继续介入治疗1～2次。结果2个月后增强CT复查,完全缓解（CR）3例;部分缓解（PR）27例,无变化（NC）9例,进展（PD）3例,总有效率为71．4％。结论肝动脉介入治疗后联合CT导向下放射性粒子植入治疗肝脏肿瘤,并发症发生率低,治疗效果较二者单一治疗有所提高,是治疗肝脏肿瘤的一种有效方法。     

^125I放射性粒子植入联合GP方案治疗老年非小细胞肺癌疗效观察

目的评价^125I放射性粒子植入联合GP方案治疗老年非小细胞肺癌（NSCLC）的可行性、安全性及其疗效。方法40例NSCLC中,初治24例,复治16例。男32例,女8例。年龄60～75岁。均行CT引导下瘤体内^125I粒子植入后3～5天,予GP方案：GEM1000mg／m^2,静滴30min,第1、8、15天;DDP30mg／m^2,静滴,第1～3天,28d为一周期,化疗2～4个周期。粒子植入后2个月（即化疗2周期后）进行近期疗效及毒副反应评价。结果^125I放射性粒子植入2个月后,40例患者全部可评价疗效。全组CR9例,PR23例,SD5例,PD3例,总有效率80．0％。初治组24例中,CR6例,PR14例,SD3例,PD1例,有效率83．3％;复治组16例中,CR3例,PR9例,SD2例,PD2例,有效率75．0％,两组差异无显著性（P〉0．05）。结论^125I放射性粒子植入联合GP方案化疗对不能手术的老年NSCLC患者是一种安全、可行、有效的治疗方法。     

^125I对比^103Pd治疗低危前列腺癌的系统评价

背景与目的：粒子植入近距离放射治疗是早期前列腺癌的主要治疗手段．常用核素粒子为^125I或^103Pd,二者在前列腺癌治疗的并发症和结果方面存有差异。本文用系统评价的方法分析^125I或^103Pd近距离放射治疗低危前列腺癌的疗效和副作用,为临床决策提供指导性依据。方法：采用文献检索和手工检索的方式搜集2008年5月以前有关^125I或^103Pd治疗低危前列腺癌的随机对照试验的文献资料,根据Cochrane Handbook4．2．6质量评价标准进行评价,由两位研究者交叉核对纳入试验的结果,用RevMan5．0进行统计学分析。结果：共纳入6个随机对照研究．1406例患者。^125I或^103Pd治疗低危前列腺癌生物学无进展生存率差异没有统计学意义（RR=0．97,95％CI=0．93～1．01）;治疗后1个月^103Pd组副作用较^125I组明显,治疗后6个月^125I组副作用较^103Pd明显,治疗后12个月两种核素副作用无差别。结论：使用^125I或^103Pd治疗低危前列腺癌疗效相似,副作用在治疗后不同时间点有差异。     

CT引导下^125I放射性微粒植入治疗盆腔转移瘤

目的：探讨放射性^125I粒子立体种植在盆腔转移瘤中的疗效。方法：通过三维粒子TPS系统确定粒子数量、针距、层距,CT引导下经皮穿刺永久性植入^125I粒子在盆腔转移瘤内。结果：24例病人治疗后病灶不同程度缩小,疼痛程度明显缓解。结论：CT引导下永久植入^125I粒子近距离治疗实体肿瘤具有微创、靶区剂量高、适形度好等优点,具有一定的临床价值。     

（125）I放射粒子永久性植入治疗激素难治性前列腺癌

目的探讨125I放射粒子永久性植入治疗激素难治性前列腺癌的临床疗效及其价值。方法直肠B超引导下,经会阴穿刺前列腺125I放射粒子植入治疗激素难治性前列腺癌22例,其中3例合并骨转移。结果 22例手术顺利,平均植入125I放射粒子42粒,平均手术时间60分钟,平均住院时间5天,术后随访8-28月,术后3月前列腺缩小,术后短期IPSS评分上升,但3月后开始好转。完全反应16例,部分反应3例,病情稳定3例,PSA无进展生存率100.0%,未发生严重并发症。结论 125I放射粒子植入治疗激素难治性前列腺癌安全、微创、并发症发生率低,疗效肯定、患者生活质量高。     

~(125)I粒子植入联合支气管动脉灌注化疗栓塞治疗肺鳞癌的临床应用

目的探讨125I粒子植入联合支气管动脉灌注化疗栓塞治疗肺鳞癌的临床价值。方法选取2010年1月至2012年4月间收治的30例肺鳞癌患者,先行支气管动脉灌注化疗栓塞术,2⁴d之后行125I粒子植入术,术前采用计算机治疗计划系统(TPS)模拟布源,计算术中所需125I粒子的总活度及粒子数量。在CT引导下,将125I粒子植入瘤体区。术后1、2、4个月时行CT扫描,参照世界卫生组织(WHO)实体肿瘤疗效评价标准进行评价。结果125I粒子植入联合支气管动脉灌注化疗栓塞治疗后1、2、4个月的有效率分别为63.3%、93.3%和96.7%。全组30例患者均全部完成治疗,所有患者未出现严重并发症,化疗不良反应轻。结论125I粒子植入联合支气管动脉灌注化疗栓塞术作为治疗肺鳞癌患者的一种重要方法,临床疗效较为确切,治愈率较高,比较安全,值得推广应用。     

CT引导下经皮穿刺植入放射性125I粒子治疗肺癌的临床应用

目的 探讨CT引导下经皮穿刺植入放射性125I粒子的肺癌治疗方法,观察临床疗效和不良反应.方法 于2004年6月-2005年10月,经CT引导125I粒子植入治疗肺癌32例.所有病例均行术前TPS制定治疗计划,术后质量验证.全部患者均植入0.5 mCi-1.0 mCi的放射性粒子,12-60颗.结果 植入病例全部成功,无死亡,部分出现气胸、出血,术后1周复查外周血象、1月复查CT及临床观察无毒副反应,术后定期复查CT,未出现放射损伤症状,未发现粒子脱落或游走等并发症.CR 22.58%、PR 61.29%、SD 12.9%、PD 3.2%.中位生存期大于12个月.结论 CT引导下经皮穿刺放射性125I粒子近距离照射治疗肺癌安全、有效,并且创伤小、并发症少.     

Five-year biochemical outcome after prostate brachytherapy for hormone-naive men ≤ 62 years of age

To evaluate 5-year biochemical disease-free outcome for hormone naïve men 62 years of age or less who underwent transperineal ultrasound-guided permanent prostate brachytherapy.

76 patients underwent transperineal ultrasound guided prostate brachytherapy using either ¹⁰³Pd or ¹²⁵I for clinical T1b–T2b N×M0 (1997 AJCC) adenocarcinoma of the prostate gland from April 1995 to October 1999. No patient was lost to follow-up, and no patient underwent pathologic lymph-node staging. 47 patients were implanted with either ¹⁰³Pd or ¹²⁵I monotherapy, and 29 patients received moderate-dose external-beam radiation therapy followed by a prostate brachytherapy boost. No patient received hormonal manipulation. The median patient age was 58 years (range, 48–62 years). The median follow-up was 37 months (range, 14–70 months). Follow-up was calculated from the day of implantation. Biochemical disease-free survival was defined by the American Society of Therapeutic Radiation and Oncology (ASTRO) consensus definition.

The actuarial 5-year biochemical disease-free survival rate was 98.7%. For patients with low-, intermediate-, and high-risk disease, 97.7%, 100%, and 100%, respectively, were free of biochemical failure. The median posttreatment prostate-specific antigen (PSA) for the entire group was 0.2 ng/mL. When stratified by risk group, the median posttreatment PSA was 0.2, 0.15, and 0.1 for patients with low-, intermediate-, and high-risk disease, respectively.

With a median follow-up of 37 months, hormone naïve patients ≤ 62 years of age have a high probability of 5-year biochemical disease-free survival following permanent prostate brachytherapy with an apparent plateau on the PSA curve.     

超声引导下125 I粒子植入治疗中晚期肝癌

目的：探讨超声引导下 125 I粒子植入治疗中晚期肝癌的疗效。方法：采用三维治疗计划系统（3D2TPS）对58例肝癌病人74个病灶行彩超引导下将125 I粒子植入肝肿瘤内。结果：74个可评价的病灶完全缓解（CR）30个,部分缓解（PR）32个,无变化（SD）11个,进展（PD）1个。总有效率为81．58％。结论：超声引导下经皮穿刺植入 125 I粒子治疗中晚期肝癌安全、有效。     

Urinary morbidity following ultrasound-guided transperineal prostate seed implantation.

PURPOSE: To assess the urinary morbidity experienced by patients undergoing ultrasound-guided, permanent transperineal seed implantation for adenocarcinoma of the prostate. METHODS AND MATERIALS: Between September 1992 and September 1997, 693 consecutive patients presented with a diagnosis of clinically localized adenocarcinoma of the prostate, and were treated with ultrasound-guided transperineal interstitial permanent brachytherapy (TPIPB). Ninety-three patients are excluded from this review, having received neoadjuvant antiandrogen therapy. TPIPB was performed with 125I in 165 patients and with 103Pd in 435 patients. Patients treated with implant alone received 160 Gy with 125I (pre TG43) or 120 Gy with 103Pd. One hundred two patients received preimplant, pelvic external beam radiation (XRT) to a dose of either 41.4 or 45 Gy because of high-risk features including PSA > or = 10 and/or Gleason score > or = 7. Combined modality patients received 120 Gy and 90 Gy, respectively for 125I or 103Pd. All patients underwent postimplant cystoscopy and placement of an indwelling Foley catheter for 24-48 h. Follow-up was at 5 weeks after implant, every 3 months for the first 2 years, and then every 6 months for subsequent years. Patients completed AUA urinary symptom scoring questionnaires at initial consultation and at each follow-up visit. Urinary toxicity was classified by the RTOG toxicity scale with the following adaptations; grade 1 urinary toxicity was symptomatic nocturia or frequency requiring none or minimal medical intervention such as phenazopyridine; grade 2 urinary toxicity was early obstructive symptomatology requiring alpha-blocker therapy; and grade 3 toxicity was considered that requiring indwelling catheters or posttreatment transurethral resection of the prostate for symptom relief. Log-rank analysis and Chi-square testing was performed to assess AUA score, prostate size, isotope selection, and the addition of XRT as possible prognosticators of postimplant urinary toxicity. The prostate volume receiving 150% of the prescribed dose (V150) was studied in patients to assess its correlation with urinary toxicity. RESULTS: Median follow-up was 37 months (range 6-68). Within the first 60 days, 37.3% of the patients reported grade 1 urinary toxicity, 41% had grade 2, and 2.2% had grade 3 urinary toxicity. By 6 months, 21.4% still reported grade 1 urinary toxicity, whereas 12.8% and 3% complained of grade 2 and 3 urinary difficulties, respectively. Patients with a preimplant AUA score < or = 7 had significantly less grade II toxicity at 60 days compared to those with an AUA score of >7 (32% vs. 59.2%, respectively, p = 0.001). Similarly, prostatic volumes < or = 35 cc had a significantly lower incidence of grade II urinary toxicity (p = 0.001). There was no difference in toxicity regarding the isotope used (p = 0.138 at 60 days, p = 0.45 at 6 months) or the addition of preimplant XRT (p = 0.069 at 60 days, p = 0.84 at 6 months). Twenty-eight patients (4.7%) underwent TURP after 3 isotope half-lives for protracted obstructive symptoms. Five of these men (17%) developed stress incontinence following TURP, but all patients experienced relief of their obstructive symptoms without morbidity at last follow-up. The percent of the prostate receiving 150% of the prescribed dose (V150) did not predict urinary toxicity. CONCLUSIONS: TPIPB is well tolerated but associated with mild to moderate urinary morbidity. Pretreatment prostatic volume and AUA scoring were shown to significantly predict for grade 2 toxicity while the use of preimplant, pelvic XRT and isotope selection did not. Patients undergoing TURP for protracted symptoms following TPIPB did well with a 17% risk of developing stress incontinence. V150 did not help identify patients at risk for urinary morbidity. As transperineal prostate implantation is used more frequently the associated toxicities and the definition of possible pretreatment prognostic factors is necessary to     

Brachytherapy with transperineal (125)Iodine seeds for localized prostate cancer.

BACKGROUND AND PURPOSE: To analyze the treatment results of transperineal (125)Iodine seeds in localized prostate cancer. PATIENTS AND METHODS: Between 1985 and 1996, 102 patients with T1-T2 N0 prostate cancer were treated with transperineal (125)Iodine seed implants at the Academic Medical Centre in Amsterdam. Tumours were classified as T1c in four patients, T2a in 73 patients and T2b in 25 patients. The mean pre-treatment PSA was 17 ng/ml. The (125)Iodine seeds were implanted transperineally under transrectal ultrasound guidance. The mean prostate volume was 31 ml (range 15-48 ml). An average of 49 seeds (range 29-74) was implanted. The dose to the periphery of the prostate was 160 Gy. Until 1988, 27 patients had additional external pelvic irradiation to a dose of 40 Gy in 20 daily fractions of 2 Gy. RESULTS: The 5- and 7-year actuarial survival rates were 77 and 63%, respectively (median 102 months). Ten patients (9.5%) died from prostate cancer. The 5- and 7-year clinical progression rates were 12 and 17%, respectively. Biochemical failure rates at 5 and 7 years were 39 and 44%, respectively. Age, alkaline phosphatase, creatinine, differentiation grade, additional treatment, staging procedure, number of seeds, prostate volume, treatment period and PSA were analyzed as prognostic factors. Only pre-treatment PSA was a prognosticator of clinical and biochemical outcome but not of survival. Biochemical control at 6 years varied from 30% for pre-treatment PSA values higher than 20 ng/ml to 95% for values < or =8 ng/ml. Forty-one out of 49 patients who were sexually active before brachytherapy maintained sexual function during the follow-up. Complete urinary incontinence occurred in one patient. No rectal complications were seen in patients receiving brachytherapy alone. CONCLUSIONS: Transperineal (125)Iodine seeds brachytherapy in localized prostate cancer achieves a good clinical control and overall survival with acceptable late toxicity. Biochemical failure was strongly correlated to the pre-treatment PSA value.