Prempree T, Amornmarn R, Patanaphan V
Cancer. 1984 Aug 15;54(4):729-33. doi: 10.1002/1097-0142(1984)54:4<729::aid-cncr2820540423>3.0.co;2-l.
Analysis of 21 patients with primary carcinoma of the female urethra who were treated by radiation only, from 1961 to 1980, is presented. Of 21 patients studied, 14 were treated for curative intent, 6 for palliation, and 1 patient did not finish the treatment as planned. For the curative group, radiation treatment was highly individualized and integrated with a special interest in brachytherapy. The authors were able to obtain excellent local control and subsequent 5-year-disease-free survival in Stage I, II, IIIA, IIIB, IIIC, and IV. The overall local control was 11 of 14 (78%) while achieving 77% 5-year disease-free survival. The bladder neck involvement continues to be a therapeutic problem and represents the only failure site. Factors responsible for the prognosis of this cancer are the extent of the cancer (clinical stage), location, individualization, and integration of the external beam and brachytherapy. Involvement of the vulva or vagina did not alter the good outcome, but involvement of the bladder neck, bladder, parametrium, and inguinal node represented a poor prognosis. Palliative irradiation treatment for those whose diseases were beyond cure can only offer a short-term, symptom-free result in 70% (5 of 7) of cases treated. No major complications occurred as a consequence of radiation treatment. Sample cases, particularly with brachytherapy and dosimetric analysis, are discussed.
本文对1961年至1980年间仅接受放疗的21例女性尿道原发性癌患者进行了分析。在研究的21例患者中，14例接受了根治性治疗，6例接受了姑息性治疗，1例未按计划完成治疗。对于根治性治疗组，放射治疗高度个体化，并特别关注近距离放疗。作者在I期、II期、IIIA期、IIIB期、IIIC期和IV期患者中均获得了良好的局部控制及随后的5年无病生存率。总体局部控制率为14例中的11例（78%），5年无病生存率为77%。膀胱颈受累仍然是一个治疗难题，是唯一的失败部位。影响该癌症预后的因素包括癌症范围（临床分期）、位置、个体化以及外照射和近距离放疗的综合应用。外阴或阴道受累并不影响良好的治疗效果，但膀胱颈、膀胱、子宫旁组织和腹股沟淋巴结受累则预后较差。对那些疾病无法治愈的患者进行姑息性放射治疗，在70%（7例中的5例）的治疗病例中只能提供短期的无症状结果。放疗未导致任何严重并发症。文中讨论了一些病例，特别是近距离放疗和剂量分析方面的病例。
