Raynal M, Chassagne D, Decroix Y, Pierquin B
J Radiol Electrol Med Nucl. 1977 May;58(5):399-403.
46 cases of epithelioma of the penis treated by endocurietherapy (Iridium 192) are analysed, with a minimum follow up to of 5 years. The local results appear to be excellent for small lesions, of the order of 20 mm, with only 2 recurrences out of 14 cases. With a slight potential of lymphatic spread, 12 of the patients are apparently cured. The organ has been preserved in perfect functional state. More extensive lesions, but less than 40 mm in size, have a less satisfactory prognosis by virtue of more frequent lymph node spread, difficult to control, and their general course. However local results remain quite respectable, despite 5 recurrences out of 25 cases, 3 of which were easily "salvaged" by surgery. 12 of these patients are apparently cured and in 9 the organ has been preserved in satisfactory functional condition. By contrast, massive forms, larger than 40 mm, recur or necrose and thus represent a poor indication for curietherapy. In conclusion it may be said that endocurietherapy for carcinoma of the penis, by virtue of a technique rendered opitmal by accurate prior dosimetry, is certainly an excellent therapeutic option for all small or moderately extensive lesions, avoiding mutilation. The presence of lymph node involvement has an unfavourable influence on prognosis.
对46例采用腔内近距离治疗（铱192）的阴茎上皮瘤患者进行了分析，最短随访时间为5年。对于直径约20毫米的小病灶，局部治疗效果似乎极佳，14例中仅有2例复发。由于存在轻微的淋巴转移可能性，12例患者显然已治愈。阴茎器官保持了完美的功能状态。对于直径小于40毫米但范围更广的病灶，由于更频繁的淋巴结转移、难以控制以及其总体病程，预后不太令人满意。然而，尽管25例中有5例复发，其中3例通过手术很容易“挽救”，局部治疗结果仍然相当可观。这些患者中有12例显然已治愈，9例患者的阴茎器官保持了令人满意的功能状态。相比之下，直径大于40毫米的大块病灶会复发或坏死，因此是近距离治疗的不良适应症。总之，可以说，由于精确的术前剂量测定使技术达到最佳，阴茎癌的腔内近距离治疗对于所有小病灶或中等范围的病灶肯定是一种极佳的治疗选择，可避免阴茎切除。淋巴结受累对预后有不利影响。
