Ravi R, Chaturvedi H K, Sastry D V
Department of Genitourinary Surgery, Cancer Institute (WIA), Adyar, Madras, India.
Br J Urol. 1994 Nov;74(5):646-51. doi: 10.1111/j.1464-410x.1994.tb09199.x.
To study the effectiveness of radiation therapy (RT) for the primary tumour and for groin node and distant metastases in patients with squamous cell carcinoma of the penis.
Between January 1959 and June 1988, 156 patients with negative lymph nodes in the groin underwent RT of the primary tumour. RT was also administered to 120 patients with lymph node involvement in the groin and to nine with distant metastases.
Local control of the primary tumour was achieved in 65% of patients with RT alone and in another 33% with salvage surgery. Lymph node recurrence in the groin was seen in 11% of patients and the corrected 5-year disease-free survival was 87%. Pre-operative inguinal RT was useful in patients with mobile lymph nodes > or = 4 cm in size in the groin, with only 8% of such lymphadenectomy specimens showing perinodal infiltration and only 3% of such patients having post-operative groin recurrences. Pelvic and/or para-aortic RT was ineffective in patients with pelvic node metastases. Palliative RT resulted in amelioration of symptoms in 56% of patients with fixed lymph nodes in the groin, all five patients with painful bony metastases and one of two patients with cord compression and paraplegia.
Radiation therapy is ideal for patients with T1 and T2 primary cancers of the penis. Pre-operative RT is useful for patients with mobile lymph nodes > or = 4 cm in size in the groin. RT provides effective palliation in patients with advanced regional disease and/or distant metastases.
研究放射治疗（RT）对阴茎鳞状细胞癌患者原发性肿瘤、腹股沟淋巴结及远处转移的疗效。
1959年1月至1988年6月期间，156例腹股沟淋巴结阴性的患者接受了原发性肿瘤的RT治疗。120例腹股沟淋巴结受累患者及9例有远处转移的患者也接受了RT治疗。
单纯RT治疗使65%的患者实现了原发性肿瘤的局部控制，另有33%的患者通过挽救性手术实现了局部控制。11%的患者出现腹股沟淋巴结复发，校正后的5年无病生存率为87%。术前腹股沟RT对腹股沟可活动淋巴结≥4 cm的患者有用，此类淋巴结切除标本仅8%显示淋巴结周围浸润，此类患者术后腹股沟复发率仅为3%。盆腔和/或腹主动脉旁RT对盆腔淋巴结转移患者无效。姑息性RT使56%腹股沟淋巴结固定的患者、所有5例有疼痛性骨转移的患者以及2例脊髓压迫和截瘫患者中的1例症状得到改善。
放射治疗对阴茎T1和T2期原发性癌症患者是理想的。术前RT对腹股沟可活动淋巴结≥4 cm的患者有用。RT对晚期局部疾病和/或远处转移患者提供有效的姑息治疗。
