Aliev B M, Tkachev S I, Filippiuk V V
Med Radiol (Mosk). 1983 Jun;28(6):25-30.
Three variants of gamma-beam therapy of prostatic cancer were worked out on the basis of a thorough topometric preparation, an analysis of dose distributions using computer, and taking account of tumor dissemination. It has been shown that moving one- or two-field gamma-beam therapy is indicated in cases when tumor lies within the limits of the prostate only. When it affects regional lymph nodes the combination of moving gamma-beam therapy with static 4-field cross irradiation with the ratio of doses from the front and back fields 2:1 is recommended. When tumor involves the nearest lymphatic collectors gamma-beam therapy is supplemented by estrogens with stage-by-stage irradiation of primary tumor, regional lymph nodes (by the above schemes) and the paraaortal group of lymph nodes from 2 opposite shaped fields, a focal dose to these nodes being 30-40 Gy only. The summary focal dose to the regional lymph nodes is 45-50 Gy, to primary tumor 65-70 Gy. The above variants of gamma-beam therapy were used for the treatment of 69 patients with prostatic cancer, Stages II-IV. Not a single patient developed marked reactions and late complications 6-36 mos. after therapy, 61% of the patients lived over 3 yrs.
在进行精确的拓扑测量准备、利用计算机分析剂量分布并考虑肿瘤扩散情况的基础上，制定了三种前列腺癌伽马射线治疗方案。结果表明，仅当肿瘤局限于前列腺范围内时，才适合采用单野或双野移动伽马射线治疗。当肿瘤累及区域淋巴结时，建议将移动伽马射线治疗与静态四野交叉照射相结合，前后野剂量比为2:1。当肿瘤累及最近的淋巴管时，伽马射线治疗需辅以雌激素，并对原发肿瘤、区域淋巴结（按上述方案）和腹主动脉旁淋巴结组进行分阶段照射，对这些淋巴结的局部剂量仅为30 - 40 Gy。区域淋巴结的总局部剂量为45 - 50 Gy，原发肿瘤为65 - 70 Gy。上述伽马射线治疗方案用于治疗69例II - IV期前列腺癌患者。治疗后6 - 36个月，无一例患者出现明显反应和晚期并发症，61%的患者存活超过3年。
