Borghede G, Hedelin H, Holmäng S, Johansson K A, Aldenborg F, Pettersson S, Sernbo G, Wallgren A, Mercke C
Department of Oncology, Sahlgrenska University Hospital, Göteborg University, Sweden.
Radiother Oncol. 1997 Sep;44(3):237-44. doi: 10.1016/s0167-8140(97)00121-7.
To evaluate the treatment outcome after radical radiotherapy of localized prostate cancer in 50 patients (38 patients with stage T1-2 and 12 patients with stage T3) after a median follow-up time of 45 months (range 18-92 months).
The treatment was given by combination of external beam radiotherapy (50 Gy) and brachytherapy (2 x 10 Gy). The brachytherapy was given using TRUS-guided percutaneously inserted temporary needles with a high dose rate remote afterloading technique with Ir-192 as the radionuclide source. Three target definitions and dose levels inside the prostate gland were used. Local control was evaluated by digital rectal examination, TRUS-guided biopsies and serum PSA evaluations.
Clinical and biopsy verified local control was achieved in 48 of the 50 (96%) patients; for stage T1-2 in 37 of 38 (97%) patients and for stage T3 in 11 of 12 (92%) patients. A posttreatment serum PSA level < or =1.0 ng/ml was seen in 42 (84%) patients, values from >1.0 to < or =2.0 ng/ml were seen in four (8%) patients and values exceeding 2.0 were seen in four (8%) patients. The late toxicity was minimal.
The local control results and the minimal toxicity after the combined radiotherapy treatment are promising. However, long term results are necessary before general use.
评估50例局限性前列腺癌患者（38例T1-2期患者和12例T3期患者）在接受根治性放疗后，中位随访时间45个月（范围18-92个月）的治疗结果。
采用外照射放疗（50 Gy）和近距离放疗（2×10 Gy）联合治疗。近距离放疗采用经直肠超声引导经皮插入临时针，以铱-192作为放射性核素源的高剂量率远程后装技术。前列腺内使用了三种靶区定义和剂量水平。通过直肠指检、经直肠超声引导下活检和血清前列腺特异抗原（PSA）评估来评价局部控制情况。
50例患者中有48例（96%）实现了临床和活检证实的局部控制；T1-2期38例患者中有37例（97%），T3期12例患者中有11例（92%）。42例（84%）患者治疗后血清PSA水平≤1.0 ng/ml，4例（8%）患者PSA值在>1.0至≤2.0 ng/ml之间，4例（8%）患者PSA值超过2.0 ng/ml。晚期毒性极小。
联合放疗后的局部控制结果和极小的毒性是有前景的。然而，在广泛应用之前需要长期结果。
