Lee W R, McCollough W M, Mendenhall W M, Marcus R B, Parsons J T, Million R R
Department of Radiation Oncology, University of Florida College of Medicine, Gainesville 32610-0385.
Cancer. 1993 Sep 15;72(6):2058-65.
There is little published information pertaining to elective inguinal lymph node irradiation for carcinomas originating in the pelvis that place the inguinal lymph nodes at risk.
Between October 1964 and October 1988, 164 patients with primary carcinomas originating in the pelvis that placed the inguinal lymph nodes at risk for subclinical disease received elective inguinal lymph node irradiation at the University of Florida. All patients had a minimum follow-up of 2 years from the start of radiation therapy. Primary sites included the penis, urethra, vulva, anal canal, distal rectum (within 4 cm of the verge), and the cervix or vagina when the tumor involved the distal one-third of the vagina. In 148 patients, both groins were clinically negative; in 16 patients, one groin was positive and the other negative by clinical examination. Treatment techniques were individualized according to the primary site. Tumor doses to the inguinal lymph nodes varied, although more than 70% of patients received 4500-5000 cGy (range, 2650-6780 cGy) over 5 weeks (range, 2-7 weeks) at 180-200 cGy per fraction. Patients were excluded from the analysis of disease control in the inguinal area if they died less than 2 years from treatment with the inguinal lymph nodes continuously disease free or if they experienced recurrence at the primary site with the inguinal lymph nodes clinically negative at the time of recurrence.
The inguinal lymph node control rate was 96% (101 of 105). No patient in whom recurrent disease developed in the inguinal lymph nodes underwent salvage therapy.
Elective irradiation of the inguinal lymph nodes is highly effective in controlling subclinical disease from carcinomas originating in the pelvis and can be accomplished with minimal acute or long-term complications.
关于对起源于骨盆且使腹股沟淋巴结有受累风险的癌进行选择性腹股沟淋巴结照射的已发表信息很少。
1964年10月至1988年10月期间，164例起源于骨盆且使腹股沟淋巴结有亚临床疾病风险的原发性癌患者在佛罗里达大学接受了选择性腹股沟淋巴结照射。所有患者从放疗开始至少随访2年。原发部位包括阴茎、尿道、外阴、肛管、直肠远端（距肛缘4 cm以内），以及肿瘤累及阴道远端三分之一时的宫颈或阴道。148例患者双侧腹股沟临床检查均为阴性；16例患者一侧腹股沟临床检查为阳性，另一侧为阴性。治疗技术根据原发部位个体化。腹股沟淋巴结的肿瘤剂量各不相同，尽管超过70%的患者在5周（范围2 - 7周）内接受4500 - 5000 cGy（范围2650 - 6780 cGy），每次分割剂量为180 - 200 cGy。如果患者在腹股沟淋巴结持续无病的情况下治疗后不到2年死亡，或者在复发时腹股沟淋巴结临床检查为阴性但原发部位出现复发，则被排除在腹股沟区疾病控制分析之外。
腹股沟淋巴结控制率为96%（105例中的101例）。腹股沟淋巴结出现复发性疾病的患者均未接受挽救治疗。
选择性照射腹股沟淋巴结对控制起源于骨盆的癌的亚临床疾病非常有效，并且可以在急性或长期并发症最少的情况下完成。
