Mazeron J J, Bolla M
Centre des tumeurs, groupe hospitalier Pitié-Salpêtrière, Paris, France.
Cancer Radiother. 1997;1(5):423-30. doi: 10.1016/s1278-3218(97)89563-7.
Radical prostatectomy after pelvic lymphadenectomy is an effective treatment for patients with T1-2 pN0 adenocarcinoma of the prostate. However, pathologic analysis of resected tissue reveals that in 20 to 40% of clinical stage B lesions, the tumour has extended locally beyond the prostate. This infra-clinical disease may be the origin of local relapse. Radiation oncologists are often asked to deliver post-operative irradiation. There is sufficient evidence in the literature that postoperative radiation therapy can improve local control rate for patients with pT3 pN0 adenocarcinoma of the prostate; however, the effect of this radiotherapy on survival in this category of patients remains unclear. It is the reason why randomised clinical trials have been implemented for investigating the role of pelvic external irradiation with respect to the effects on local control, acute and late morbidity, overall survival and cancer-related survival, and for better defining the selective indications of radiotherapy, regarding pathological data.
盆腔淋巴结清扫术后行根治性前列腺切除术是T1-2 pN0前列腺腺癌患者的有效治疗方法。然而，对切除组织的病理分析显示，在20%至40%的临床B期病变中，肿瘤已局部侵犯至前列腺以外。这种亚临床疾病可能是局部复发的根源。放射肿瘤学家经常被要求进行术后放疗。文献中有充分的证据表明，术后放疗可提高pT3 pN0前列腺腺癌患者的局部控制率；然而，这种放疗对这类患者生存的影响仍不清楚。这就是为什么要开展随机临床试验，以研究盆腔外照射在局部控制、急性和晚期发病率、总生存以及癌症相关生存方面的作用，并根据病理数据更好地确定放疗的选择性适应证。
