Pötter R, Müller R P, Luttke G
Radiologische Klinik der Westfälischen Wilhelms-Universität Münster.
Strahlenther Onkol. 1988 May;164(5):260-5.
A retrospective analysis was made about the results achieved in 64 patients after combined surgical and radiotherapeutic treatment. The tumor areas were irradiated by fast electrons or cobalt 60 with 50 to 55 Gy, the lymph nodes received doses of 45 to 55 Gy. Local tumor control was achieved in 27 out of 28 patients irradiated immediately after surgery (96%). In case of demonstrated lymph node invasion, local control was achieved in 14 out of 19 cases (74%). The median survival was 9.6 years for patients in stage T1/2, N0, M0 and 2.5 years for patients in stage T1-4, N+, M0. The first two years following to therapy were decisive for the prognosis. Among those of our patients who developed recurrences during this period, not one could be cured in the long run. Two years after the end of therapy, the survival probability of patients without lymph node metastases becomes comparable to the survival curve of normal male population of the same age. In the treatment of penile carcinoma, a gradual proceeding depending on the stage is recommended for the combination of surgery and radiotherapy. In case of lymph node metastases, the application of adjuvant chemotherapy should be taken into consideration.
对64例接受手术和放射治疗联合治疗的患者的治疗结果进行了回顾性分析。肿瘤区域用快电子或钴60照射，剂量为50至55 Gy，淋巴结接受45至55 Gy的剂量。28例术后立即接受照射的患者中有27例实现了局部肿瘤控制（96%）。在证实有淋巴结侵犯的情况下，19例中有14例实现了局部控制（74%）。T1/2、N0、M0期患者的中位生存期为9.6年，T1 - 4、N+、M0期患者的中位生存期为2.5年。治疗后的头两年对预后起决定性作用。在我们的患者中，在此期间出现复发的患者，从长远来看无一例能够治愈。治疗结束两年后，无淋巴结转移患者的生存概率与同年龄正常男性人群的生存曲线相当。在阴茎癌的治疗中，建议根据分期逐步进行手术和放疗的联合治疗。如果有淋巴结转移，应考虑应用辅助化疗。
