Thompson I M, Rounder J B, Spence C R, Rodriguez F R
Department of Surgery, Brooke Army Medical Center, Fort Sam Houston, TX 78234-6200.
Cancer. 1988 Apr 1;61(7):1464-6. doi: 10.1002/1097-0142(19880401)61:7<1464::aid-cncr2820610732>3.0.co;2-f.
Radiotherapy has been a major method of treating localized carcinoma of the prostate. It is becoming increasingly apparent that failures of radiotherapy do occur and can be predicted by postradiation biopsy. Salvage radical prostatectomy can be offered to these patients. The authors report on five patients with residual carcinoma after radiotherapy. Three patients had undergone external-beam radiotherapy and two had undergone interstitial plus external-beam radiotherapy. All salvage radical prostatectomies were uncomplicated technically. One patient had a myocardial infarction believed to be unrelated to the procedure. Two patients, observed for over 1 year, have mild residual stress incontinence but residual adenocarcinoma proved to be localized to the surgical specimen in all but one patient. One patient underwent nerve-sparing radical prostatectomy and has had return of sexual function. Salvage radical prostatectomy is a viable option for patients who have histologically proven residual carcinoma after definitive radiotherapy.
放射疗法一直是治疗局限性前列腺癌的主要方法。越来越明显的是，放射治疗失败确实会发生，并且可以通过放疗后活检来预测。对于这些患者可以提供挽救性根治性前列腺切除术。作者报告了5例放疗后残留癌患者。3例患者接受了外照射放疗，2例患者接受了间质加外照射放疗。所有挽救性根治性前列腺切除术在技术上均无并发症。1例患者发生心肌梗死，认为与手术无关。2例患者观察超过1年，有轻度残余压力性尿失禁，但除1例患者外，其余患者的残余腺癌均局限于手术标本。1例患者接受了保留神经的根治性前列腺切除术，性功能已恢复。对于在确定性放疗后经组织学证实有残留癌的患者，挽救性根治性前列腺切除术是一种可行的选择。
