Forman J D, Wharam M D, Lee D J, Zinreich E S, Order S E
Int J Radiat Oncol Biol Phys. 1986 Feb;12(2):185-9. doi: 10.1016/0360-3016(86)90092-1.
Thirty-four patients with carcinoma of the prostate treated by prostatectomy received postoperative external beam radiation. Sixteen patients were treated within 4 months of radical prostatectomy (group 1), 12 patients were treated for prostate carcinoma following initial enucleative prostatectomy for benign hypertrophy (group 2) and 6 patients were treated for palpable local recurrence 4 to 10 years following radical prostatectomy (group 3). The indications for postoperative radiotherapy following radical prostatectomy included extracapsular extension, seminal vesicle invasion, peri-prostatic soft tissue involvement, positive margins or palpable local recurrence. Eighty-five percent of the patients received whole pelvic radiation. All patients then had a 2-week treatment rest followed by a reduced portal to the prostate bed to a dose of 6500 cGy. The local control rate after radiotherapy was 100% with a median follow-up of 4 years. The 5-year actuarial survival and disease-free survival rates for all patients were 82 and 72%, respectively. In group 1, the 5-year actuarial survival and disease-free survival rates were 100 and 91%, respectively. In group 2, these rates were 77 and 64%. Three of the six patients in group 3 died within 30 months of radiotherapy. Fourteen patients (41%) had mild to moderate treatment related symptoms including seven patients (21%) with lower extremity or genital edema, five patients (15%) with urinary stress incontinence, two patients (6%) with urethral stricture and three patients (9%) with proctitis. Six of eight patients who were potent prior to radiation retained potency thereafter. No severe complications occurred. We conclude that external beam radiation therapy administered after prostatectomy resulted in an acceptable therapeutic ratio with 100% local regional control, and an acceptable complication rate (41%).
34例接受前列腺切除术治疗的前列腺癌患者术后接受了体外照射放疗。16例患者在根治性前列腺切除术后4个月内接受治疗（第1组），12例患者在因良性前列腺增生行初次剜除术后因前列腺癌接受治疗（第2组），6例患者在根治性前列腺切除术后4至10年因可触及的局部复发接受治疗（第3组）。根治性前列腺切除术后术后放疗的指征包括包膜外侵犯、精囊侵犯、前列腺周围软组织受累、切缘阳性或可触及的局部复发。85%的患者接受了全盆腔放疗。所有患者随后休息2周，然后缩小照射野至前列腺床，给予6500 cGy的剂量。放疗后的局部控制率为100%，中位随访时间为4年。所有患者的5年精算生存率和无病生存率分别为82%和72%。在第1组中，5年精算生存率和无病生存率分别为100%和91%。在第2组中，这些比率分别为77%和64%。第3组的6例患者中有3例在放疗后30个月内死亡。14例患者（41%）出现轻至中度与治疗相关的症状，包括7例（21%）下肢或生殖器水肿、5例（15%）压力性尿失禁、2例（6%）尿道狭窄和3例（9%）直肠炎。放疗前有性功能的8例患者中有6例此后保留了性功能。未发生严重并发症。我们得出结论，前列腺切除术后给予体外照射放疗可获得可接受的治疗比，局部区域控制率为100%，并发症发生率可接受（41%）。
