Keisch M E, Perez C A, Grigsby P W, Bauer W C, Catalona W
Radiation Oncology Center, Mallinckrodt Institute of Radiology, Washington University Medical Center, St. Louis, MO.
Int J Radiat Oncol Biol Phys. 1990 Dec;19(6):1503-6. doi: 10.1016/0360-3016(90)90363-o.
Since 1987, 10 patients have been treated with irradiation to a limited pelvic volume for elevation of serum prostate-specific antigen (PSA) level above expected post-radical prostatectomy levels without clinical or radiological evidence of either metastatic or locoregional disease. The patients were treated 3 to 43 months after radical prostatectomy, using bilateral 120 degrees arcs to deliver 6000 cGy to the prostatic bed. The pathologic findings of the initial surgical specimens for all patients were reviewed. Eight patients had pathologic Stage C disease, and five patients had one or more positive margins. All patients had negative staging lymphadenectomies. After irradiation, eight patients had decreases in PSA levels indicative of response of isolated local disease. Through preliminary, these results suggest that post-prostatectomy PSA levels are useful for detecting subclinical local recurrence or persistence in the prostatic bed, as well as monitoring these patients' response to therapy. The value of this elective treatment remains to be documented.
自1987年以来，10例血清前列腺特异性抗原（PSA）水平升高至根治性前列腺切除术后预期水平之上、但无转移或局部区域疾病的临床或影像学证据的患者接受了有限盆腔容积的放疗。这些患者在根治性前列腺切除术后3至43个月接受治疗，采用双侧120度弧形照射，向前列腺床给予6000厘戈瑞的剂量。回顾了所有患者初始手术标本的病理结果。8例患者有病理C期疾病，5例患者有一处或多处手术切缘阳性。所有患者分期淋巴结清扫均为阴性。放疗后，8例患者PSA水平下降，提示孤立局部疾病有反应。尽管这些结果尚属初步，但表明前列腺切除术后PSA水平有助于检测前列腺床亚临床局部复发或持续存在，以及监测这些患者对治疗的反应。这种选择性治疗的价值仍有待证实。
