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[前列腺癌的淋巴转移与放射治疗]

[Lymphogenic metastasis in prostate carcinoma and radiation therapy].

作者信息

Schubert J, Kirsch E, Kelly U, Gorski J, Nitzsche H, Heidl G, Schorcht J

出版信息

Z Urol Nephrol. 1979 Mar;72(3):175-83.

PMID:463373
Abstract

Our examinations allow the following conclusions: 1. Before the beginning of a curative radiotherapy of the carcinoma of the prostate gland in a negative and questionably positive lymphogramme the pelvic lymphadenectomy with histologic examination of the lymph nodes is indicated. 2. In the negative findings of the histologically examined lymph nodes an exclusive local tumour irradiation is justified. 3. If in regional and negative findings micrometastases appear in the area of juxtaregional lymph nodes the additional curative irradiation of the pelvic lymph nodes seems to be indicated for the comprehension of the regional lymph nodes. 4. When there are micrometastases in the area of the aa. iliacae communes or macroscopically extended metastases in the regional and juxtaregional lymph area, so we regard as a rule a radiotherapy of the carcinoma of the prostate gland no more indicated and recommend a contrasexual treatment. The necessary expansion of the radiotherapy is according to our hitherto existing experiences badly tolerated by the for the most part older patients. 5. The intraoperative labelling of the prostate gland and the determination of the size of the prostate gland facilitate the localisation of the tumour for the radiotherapist.

摘要

我们的检查得出以下结论

  1. 在前列腺癌根治性放疗开始前,若淋巴造影结果为阴性或可疑阳性,则需进行盆腔淋巴结清扫术并对淋巴结进行组织学检查。2. 若组织学检查发现淋巴结为阴性,则仅进行局部肿瘤照射是合理的。3. 如果在区域检查结果为阴性的情况下,在近区域淋巴结区域出现微转移,那么为了涵盖区域淋巴结,似乎需要对盆腔淋巴结进行额外的根治性照射。4. 当在髂总动脉区域存在微转移或在区域和近区域淋巴区域出现宏观上扩展的转移时,通常我们认为不再适合进行前列腺癌放疗,而是建议采取其他治疗方法。根据我们目前的经验,大多数老年患者对放疗范围的必要扩大耐受性较差。5. 术中对前列腺进行标记以及确定前列腺大小有助于放疗医生对肿瘤进行定位。

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