Ross G, Borkon W D, Landry L J, Edwards F M, Weinstein S H, Abadir R
J Urol. 1982 Apr;127(4):699-701. doi: 10.1016/s0022-5347(17)54001-x.
Fifty-seven patients with localized carcinoma of the prostate were treated with pelvic lymphadenectomy and a reduced 125iodine implant dosage, supplemented by a moderate dose of external beam radiotherapy to the whole pelvis delivered 4 to 6 weeks later. The incidence of pelvic nodal metastases was 28 per cent and the operative morbidity was 15 per cent. Late radiation sequelae developed in 18 patients, including 15 patients with radiation proctitis (29 per cent), among whom 2 (4.6 per cent) suffered rectal ulceration and required diverting colostomy. Followup has been 2 years or longer (median 33 months) in 26 patients, of whom 22 (85 per cent) are free of disease. Three patients are living with osseous metastases or local disease and there has been 1 death of prostatic carcinoma, for an absolute 2-year survival rate of 95 per cent. Of the 7 patients with poorly differentiated tumor and of the 8 patients with positive pelvic lymph nodes 5 and 6, respectively, remain free of disease after a minimum 2-year followup. Potency has been lost in 20 per cent and reduced significantly in 30 per cent of the patients followed 18 months or longer. Prostatic biopsies on 28 asymptomatic patients 12 to 30 months after completion of therapy showed no tumor in 21 (75 per cent).
57例局限性前列腺癌患者接受了盆腔淋巴结清扫术及减少剂量的¹²⁵碘植入治疗，并在4至6周后辅以全盆腔中等剂量的外照射放疗。盆腔淋巴结转移发生率为28%，手术并发症发生率为15%。18例患者出现晚期放疗后遗症，其中15例发生放射性直肠炎（29%），其中2例（4.6%）出现直肠溃疡，需要行转流性结肠造口术。26例患者的随访时间为2年或更长（中位时间33个月），其中22例（85%）无疾病。3例患者有骨转移或局部病变，有1例前列腺癌死亡，2年绝对生存率为95%。在7例低分化肿瘤患者和8例盆腔淋巴结阳性患者中，分别有5例和6例在至少2年的随访后无疾病。在随访18个月或更长时间的患者中，20%的患者失去性功能，30%的患者性功能明显减退。治疗结束后12至30个月，对28例无症状患者进行前列腺活检，21例（75%）未发现肿瘤。
