DeLaney T F, Shipley W U, O'Leary M P, Biggs P J, Prout G R
Int J Radiat Oncol Biol Phys. 1986 Oct;12(10):1779-85. doi: 10.1016/0360-3016(86)90319-6.
Fifty-four patients with clinically and surgically localized prostatic carcinoma were treated with low-dose preoperative irradiation (1,050 cGy), pelvic lymphadenectomy, and interstitial 125Iodine implantation. The follow-up range is 2 to 9 years with a median follow-up of 5 years. Overall local tumor control is 92%. Actuarial 5-year survival is 86% and the actuarial disease-free survival at 5 years is 73%. Patients with poorly differentiated tumors have a significantly worse actuarial survival (62%) at 5 years than patients with well (95%) or moderately well differentiated tumors (93%), p = 0.04. Disease-free survival at 5 years was influenced by grade: well (100%), moderate (60%), and poor (48%), p = 0.03. Multivariate regression analysis indicates that only the degree of differentiation (p = 0.05) significantly impacts on survival. Both degree of differentiation (p = 0.04) and nodal status (p = 0.03) significantly influence disease-free survival. Potency has been maintained in 71% of patients potent at the time of implantation. Late reactions have been acceptable to date: bladder outlet obstruction (13%), mild proctitis (13%), cystourethritis (6%), incontinence (2%), and prostatic calculi (2%).
54例临床及手术确诊为局限性前列腺癌的患者接受了低剂量术前放疗（1050厘戈瑞）、盆腔淋巴结清扫术及组织间125碘植入治疗。随访时间为2至9年，中位随访时间为5年。总体局部肿瘤控制率为92%。5年精算生存率为86%，5年无病生存率为73%。肿瘤分化差的患者5年精算生存率（62%）明显低于高分化（95%）或中分化（93%）的患者，p = 0.04。5年无病生存率受肿瘤分级影响：高分化（100%）、中分化（60%）和低分化（48%），p = 0.03。多因素回归分析表明，只有分化程度（p = 0.05）对生存率有显著影响。分化程度（p = 0.04）和淋巴结状态（p = 0.03）均对无病生存率有显著影响。71%植入时仍有性功能的患者性功能得以保留。迄今为止，晚期反应均可接受：膀胱出口梗阻（13%）、轻度直肠炎（13%）、膀胱尿道炎（6%）、尿失禁（2%）和前列腺结石（2%）。
