Rost A, Brosig W, Ernst H
Helv Chir Acta. 1976 Jul;43(3):309-19.
Since 1967 we have been using preoperative radiation therapy for hypernephroma as proposed by RICHES. Radiation therapy, to include the para-aortic lymph nodes, is given in 250 rad increments 4 times weekly to a total dose of 3000 rads. After an interval of 3 weeks following the radiation therapy, we are performing the radical nephrectomy. 100 patients were treated by this method in the years 1967-1975: 32 patients were in stage I, 7 in stage II, 50 in stage III and 11 patients in stage IV. In 26 patients more than 5 years have passed since the beginning of the treatment: 46% od these survived. The survival for 3 years is 63, for 1 year after the surgery 80%. The surgical mortality rate is 2%. The object od the preoperative treatment is: 1. Devitalization of growing cells in the periphery of the tumor, thus preventing metastases and local recurrence. 2. Decreasing the size of the tumor and thereby facilitating surgery. In one-third of the cases there is radiologically demonstrable decrease in the size of the tumor mass, probably secondary to obliteration of the dilated veins in the capsule. The delay of six weeks has had no adverse effect on the outcome of the disease.
自1967年以来，我们一直按照里切斯的提议，对肾细胞癌采用术前放射治疗。放射治疗范围包括腹主动脉旁淋巴结，每周4次，每次递增250拉德，总剂量达3000拉德。放射治疗后间隔3周，我们进行根治性肾切除术。1967年至1975年期间，100例患者采用此方法治疗：I期32例，II期7例，III期50例，IV期11例。自治疗开始已有26例患者超过5年：其中46%存活。3年生存率为63%，术后1年生存率为80%。手术死亡率为2%。术前治疗的目的是：1. 使肿瘤周边生长活跃的细胞失活，从而防止转移和局部复发。2. 缩小肿瘤大小，从而便于手术。在三分之一的病例中，肿瘤块大小在放射学上可证实缩小，可能继发于包膜内扩张静脉闭塞。六周的延迟对疾病转归没有不利影响。
