Wiegel T, Bressel M, Baumann M, Schwarz R, Hübener K H
Abteilung für Strahlentherapie, Universitätskrankenhaus Hamburg-Eppendorf.
Strahlenther Onkol. 1993 Mar;169(3):152-8.
Between 1975 and 1987, 53 patients with radical retropubic prostatectomy for adenocarcinoma of the prostate (pathological stage C or D1) underwent adjuvant radiotherapy. 26 of these patients additionally underwent subcapsular orchiectomy. Radiation therapy was given to 45 patients as 40 to 50 Gy to the pelvic lymph nodes followed by a boost to the tumor bed to a total of 64 to 70 Gy. Only five of the 45 patients received treatment to prostate and pelvis developed progression, whereas four out of eight patients who were irradiated to the prostate alone showed progression (p < 0.01). The five- and ten-year disease-free survival rates of 33 patients with stage C tumors were 91% and 83%, the local control rate 97% and 94%. 20 patients with stage D1 carcinoma showed a five-year disease-free survival of 79% and a local control rate of 95%. 25/26 patients with subcapsular orchiectomy are living disease-free, 8/27 patients without hormonal manipulation had a progression of disease (p < 0.05). All 13 patients with well or moderate differentiated tumor are alive without evidence of disease, 9/40 patients with poor differentiated carcinoma have shown tumor progression (p < 0.05). Compared to published results, our data suggest, that adjuvant radiotherapy can decrease local recurrence and probably increase disease-free survival in stage C and D1 carcinoma of the prostate.
1975年至1987年间，53例因前列腺腺癌接受根治性耻骨后前列腺切除术（病理分期为C期或D1期）的患者接受了辅助放疗。其中26例患者还接受了包膜下睾丸切除术。45例患者接受放射治疗，盆腔淋巴结照射剂量为40至50 Gy，随后对肿瘤床进行追加照射，总剂量达64至70 Gy。在45例接受前列腺和盆腔治疗的患者中，只有5例出现病情进展，而仅接受前列腺照射的8例患者中有4例出现病情进展（p<0.01）。33例C期肿瘤患者的5年和10年无病生存率分别为91%和83%，局部控制率分别为97%和94%。20例D1期癌患者的5年无病生存率为79%，局部控制率为95%。26例接受包膜下睾丸切除术的患者中有25例无病存活，27例未接受激素治疗的患者中有8例出现疾病进展（p<0.05）。所有13例高分化或中分化肿瘤患者均存活且无疾病证据，40例低分化癌患者中有9例出现肿瘤进展（p<0.05）。与已发表的结果相比，我们的数据表明，辅助放疗可降低前列腺C期和D1期癌的局部复发率，并可能提高无病生存率。
