Fuse H, Katayama T, Akimoto S, Shimazaki J
Department of Urology, Faculty of Medicine, Toyama Medical and Pharmaceutical University.
Hinyokika Kiyo. 1991 Aug;37(8):801-8.
Forty-one patients with adenocarcinoma of the prostate localized in the pelvis (stage A2, NX; 3, A2, pN0; 5, B, NX; 5, B, pN0; 1, C, NX; 13, C, pN0; 7, C, pN1; 7) underwent curative external radiotherapy. Thirty-two cases were treated by fast neutron combined with or without Liniac X-ray and 9 cases were treated by Liniac X-ray. Twenty-six cases were well controlled by radiotherapy, but 15 cases recurred and were followed by endocrine therapy. The types of recurrence were local growth in 3, distant metastases in 11, and both in 1. These recurrences occurred in the cases of large prostatic carcinoma, small radiation field in NX cases or low radiation dose. The five-year disease-free survival rates of stage A2, B, C were 86, 66, and 47%, respectively and the five-year overall survival rates were 100, 100, and 53%, respectively. The cases with well differentiated carcinoma had better prognosis than those with poorly differentiated carcinoma (p less than 0.05). As 58% of the cases which were given concomitant endocrine therapy were controlled for over 2 years, endocrine therapy seems to be effective in the cases of failure after radiotherapy. Most of the complications were slight and only one case with complication of sacral decubitus needed surgical treatment. It was concluded that external radiotherapy was a good modality for prostatic carcinoma localized in the pelvis.
41例盆腔局限性前列腺腺癌患者(A2期,NX;3例,A2期,pN0;5例,B期,NX;5例,B期,pN0;1例,C期,NX;13例,C期,pN0;7例,C期,pN1;7例)接受了根治性外照射放疗。32例采用快中子联合或不联合直线加速器X线治疗,9例采用直线加速器X线治疗。26例放疗后病情得到良好控制,但15例复发并接受内分泌治疗。复发类型为局部生长3例,远处转移11例,两者皆有1例。这些复发发生在前列腺癌体积较大、NX期病例放疗野较小或放疗剂量较低的情况下。A2期、B期、C期的5年无病生存率分别为86%、66%和47%,5年总生存率分别为100%、100%和53%。高分化癌患者的预后优于低分化癌患者(p<0.05)。由于58%接受同步内分泌治疗的病例病情得到控制超过2年,内分泌治疗似乎对放疗失败的病例有效。大多数并发症轻微,只有1例发生骶部褥疮并发症需要手术治疗。结论是,外照射放疗是盆腔局限性前列腺癌的一种良好治疗方式。