Lawton C A, Cox J D, Glisch C, Murray K J, Byhardt R W, Wilson J F
Department of Radiation Oncology, Medical College of Wisconsin Affiliated Hospitals, Milwaukee.
Cancer. 1992 Jun 1;69(11):2761-6. doi: 10.1002/1097-0142(19920601)69:11<2761::aid-cncr2820691122>3.0.co;2-k.
From 1972 to 1986, 354 patients with local and locoregional adenocarcinoma of the prostate were treated with curative intent at the Medical College of Wisconsin. Fifty-six of these patients were found to have Stage D1 disease (evidence of pelvic lymph node involvement). Using external beam irradiation alone, these patients were treated aggressively to the pelvis followed by a boost to the prostate. The median dose to the prostate was 6800 cGy, and to the pelvis, it was 5040 cGy. The median period of observation after treatment was 9 years. Actuarial survival was 76% at 5 years, and disease-free survival was 61% at 5 years. Twenty-three patients had biopsy-proved pelvic lymph node involvement; the other 33 were considered to have Stage D1 disease based on abnormal computed tomographic scans, lymphangiograms, or both. Actuarial survival and disease-free survival were calculated for both groups separately, and there was no statistical difference in the results. Major complications occurred in 3.6% (two patients) of this group with Stage D1 disease. These results support the continued use of aggressive external beam irradiation in patients with locoregional adenocarcinoma of the prostate.
1972年至1986年期间，威斯康星医学院对354例患有前列腺局部及区域淋巴结腺癌的患者进行了根治性治疗。其中56例患者被发现患有D1期疾病（有盆腔淋巴结受累证据）。仅采用外照射治疗，这些患者先对盆腔进行积极照射，随后对前列腺进行追加照射。前列腺的中位剂量为6800厘戈瑞，盆腔的中位剂量为5040厘戈瑞。治疗后的中位观察期为9年。5年的精算生存率为76%，5年无病生存率为61%。23例患者经活检证实有盆腔淋巴结受累；另外33例根据计算机断层扫描、淋巴管造影或两者检查异常被认为患有D1期疾病。分别计算了两组的精算生存率和无病生存率，结果无统计学差异。该D1期疾病组中3.6%（2例患者）发生了严重并发症。这些结果支持继续对患有前列腺区域淋巴结腺癌的患者采用积极的外照射治疗。
