ADJUVANT RADIOTHERAPY FOLLOWING RADICAL PROSTATECTOMY - RESULTS AND COMPLICATIONS
ADJUVANT RADIOTHERAPY FOLLOWING RADICAL PROSTATECTOMY - RESULTS AND COMPLICATIONS
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DOI：
10.1016/s0022-5347(17)45519-4
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发表时间：
1986-01-01
影响因子：
6.6
通讯作者：
HAFERMANN, MD
中科院分区：
文献类型：
--
作者：
GIBBONS, RP;COLE, BS;HAFERMANN, MD
1954 年至 1978 年间，148 名患者因临床局限于前列腺的腺癌接受了根治性会阴前列腺切除术。本报告基于其中 45 名患者，这些患者的疾病在显微镜下已扩展到腺体以外，并进行了至少 5 年的随访。其中 22 名患者接受了辅助外照射放射治疗，23 名没有接受。各组在显着的预后变量方面具有可比性。患者的选择取决于外科医生的偏好。接受辅助放疗的 22 名患者中有 1 名 (5%) 出现局部复发，而接受单纯手术的 23 名患者中有 7 名 (30%) 出现局部复发（p 小于 0.05）。 8名局部复发患者中，7人死于该病。局部复发的延迟放射治疗通常不能有效控制疾病。平均随访时间为 9.2 年的 11 名死于前列腺癌的患者中，有 3 人接受了辅助放疗，8 人没有接受辅助放疗。 14% 的受辐射患者和 6% 的仅接受手术治疗的患者出现严重但非致命的长期并发症。大多数并发症发生在研究的前几年接受 60 钴放射治疗的患者中。当根治性会阴前列腺切除术后发现临床B期前列腺癌病理为C期时，辅助放疗可以降低随后局部复发的发生率。应权衡辅助放射治疗的潜在风险并考虑其使用，特别是对于肿瘤延伸至手术边缘或有精囊侵犯的患者。
Between 1954 and 1978, 148 patients underwent radical perineal prostatectomy for adenocarcinoma clinically confined to the prostate gland. This report is based on 45 of these patients with microscopic extension of disease beyond the gland and a minimum 5-year followup. Of the patients 22 received adjuvant external beam radiation therapy and 23 did not. The groups were comparable with regard to significant prognostic variables. Patient selection was by surgeon preference. Local recurrences were seen in 1 of 22 patients (5 percent) receiving adjuvant radiotherapy and 7 of 23 (30 percent) undergoing an operation alone (p less than 0.05). Of 8 patients with local recurrence 7 died of the disease. Delayed radiotherapy of a local recurrence generally was not effective in controlling the disease. Of the 11 patients who died of prostatic cancer with a mean followup of 9.2 years 3 received adjuvant radiotherapy and 8 did not. Severe but nonfatal long-term complications were seen in 14 percent of the irradiated patients and 6 percent of those treated with an operation alone. Most of the complications occurred in the earlier years of the study in patients who received 60cobalt radiotherapy. When clinical stage B cancer of the prostate is found to be pathological stage C following radical perineal prostatectomy, adjuvant radiotherapy can decrease the incidence of subsequent local recurrence. The potential risk of adjuvant radiation therapy should be weighed and its use considered, particularly in patients whose tumor extends to the surgical margins or who have seminal vesicle invasion.