Morton J D, Peschel R E
Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT 06510.
Int J Radiat Oncol Biol Phys. 1988 Jun;14(6):1153-7. doi: 10.1016/0360-3016(88)90392-6.
From 1974 to 1984, 307 patients with local prostate cancer (Stage A2, B, or C) were referred to the Hunter Radiation Therapy Center, Yale-New Haven Hospital for definitive radiation therapy. One hundred forty-one patients underwent an interstitial Iodine-125 implant (IMP) and 166 patients received external beam irradiation (EB). For IMP patients with Stage A2, B, and C tumors, the actuarial 5-year disease-free survival (NED) rates were 88%, 84%, and 38% and the 9-year NED survival rates were 88%, 62%, and 30%, respectively. For EB patients with Stage A2, B, and C tumors, the 5-year NED survival rates were 88%, 77%, and 43% and the 9-year NED survival rates were 74%, 63%, and 37%, respectively. The NED survival rates by histologic grade were equivalent for the IMP and EB patients. The absolute local control rate (LCR) was 77% for all of the IMP patients but if one excludes patients who were inadequately treated, the LCR was 82%. LCR in the EB patients was 86%. The LCR for Stage A2, B, and C patients treated with EB was 100%, 94%, and 82%, respectively. The LCR for Stage A2, B, and C patients treated with an adequate IMP was 100%, 83%, and 71%, respectively. The complication rate was 8.5% in the IMP patients (with 0% severe complications) and 14% in the EB patients (with 3% severe complications). Our results indicate that a carefully selected group of IMP patients (Stage A2, B) will have an equivalent NED survival rate and an excellent LCR compared to EB patients but with fewer and less severe side effects.
1974年至1984年期间，307例局部前列腺癌（A2期、B期或C期）患者被转诊至耶鲁 - 纽黑文医院的亨特放射治疗中心接受确定性放射治疗。141例患者接受了组织间碘 - 125植入治疗（IMP），166例患者接受了外照射放疗（EB）。对于A2期、B期和C期肿瘤的IMP患者，精算5年无病生存率（NED）分别为88%、84%和38%，9年NED生存率分别为88%、62%和30%。对于A2期、B期和C期肿瘤的EB患者，5年NED生存率分别为88%、77%和43%，9年NED生存率分别为74%、63%和37%。IMP和EB患者按组织学分级的NED生存率相当。所有IMP患者的绝对局部控制率（LCR）为77%，但如果排除治疗不充分的患者，LCR为82%。EB患者的LCR为86%。接受EB治疗的A2期、B期和C期患者的LCR分别为100%、94%和82%。接受充分IMP治疗的A2期、B期和C期患者的LCR分别为100%、83%和71%。IMP患者的并发症发生率为8.5%（严重并发症为0%），EB患者的并发症发生率为14%（严重并发症为3%）。我们的结果表明，与EB患者相比，经过精心挑选的一组IMP患者（A2期、B期）将具有相当的NED生存率和出色的LCR，但副作用更少且更轻。
