Prada Gómez P J, Canteli M, Alonso A, Olay L, Alonso R, Reinerio R, Juan G, Fernández J
Servicio de Urología, Hospital Central de Asturias, Oviedo, España.
Arch Esp Urol. 1999 Jan-Feb;52(1):32-8; discussion 38-9.
To analyze the 15-year results of external irradiation combined with radioactive gold grain implantation (Au198) in the treatment of adenocarcinoma of the prostate and to discuss the therapeutic perspectives.
The present study was conducted on 23 patients with localized prostate carcinoma (17 stage B; 6 stage C) that had been diagnosed and treated at our department from February 1981 to October 1986. The mean patient follow-up was 90.96 months. Au198 implantation (mean dose 3347.6 cGy) was performed through the abdominal approach prior to external irradiation (mean dose 39 Gy) with Co-60 (19 patients) or the 18-MV photon linear accelerator (4 patients). The mean fractionated dose was 180.43 cGy/day.
Overall the 15-year locoregional control rate was 61% and disease-free survival was 38%. The overall survival rate was 25%, regardless of the cause of death. The tumor control rate was 61% for stage B and 83% for stage C lesions at 15 years. The disease-free survival rate was 40% for stage B and 50% for stage C tumors. The local control and disease-free survival rates were worse for patients in whom the diagnosis had been made by TUR (p = not significant).
The locoregional tumor control and disease-free survival rates for this group of 23 patients who received combined therapy with external irradiation and radioactive gold grain implantation (Au198) were slightly lower than those obtained in another group of 104 patients treated at our Service of Radiotherapeutic Oncology with radical external radiation therapy and can be ascribed mainly to poor patient selection and inadequate radiation dose.
分析外照射联合放射性金颗粒植入（Au198）治疗前列腺癌15年的结果，并探讨治疗前景。
本研究对1981年2月至1986年10月在我科诊断并治疗的23例局限性前列腺癌患者（17例B期；6例C期）进行。患者平均随访90.96个月。在使用钴-60（19例患者）或18兆伏光子直线加速器（4例患者）进行外照射（平均剂量39 Gy）之前，通过腹部途径进行Au198植入（平均剂量3347.6 cGy）。平均分次剂量为180.43 cGy/天。
总体而言，15年局部区域控制率为61%，无病生存率为38%。总体生存率为25%，与死亡原因无关。15年时，B期病变的肿瘤控制率为61%，C期病变为83%。B期肿瘤的无病生存率为40%，C期肿瘤为50%。经TUR确诊的患者，其局部控制率和无病生存率较差（p=无显著性差异）。
这组接受外照射与放射性金颗粒植入（Au198）联合治疗的23例患者，其局部区域肿瘤控制率和无病生存率略低于我科放射肿瘤治疗科用根治性外照射治疗的另一组104例患者，这主要可归因于患者选择不当和放射剂量不足。
