前立腺癌に対する術中照射術

Abstract

前立腺癌30症例に対して術中照射術を行い, 検討した.1) 5年生存率は42.6%であり, 非術中照射群の3.2%に比べ, 良好であった.2)リンパ節検索を同時に行った恥骨後式術中照射術の方が, 経会陰式術中照射術よりも予後が良好であった.3) Stage Dに対しても術中照射術により延命が期待できる可能性がある.4)副作用として軽度の膀胱・直腸刺激症状を認めた

Between February 1982 and February 1986, 30 patients with prostatic cancer received intraoperative radiotherapy (IORT). First 10 cases were treated by the transperineal approach, and after April 1983, 20 cases were done by the retropubic approach. We chose the retropubic approach, because it has advantages over the transperineal approach, which has a risk of rectal damage, lymph-adenectomy can not be performed and the patient can not sit down for a long time after the operation. In the IORT procedure for prostatic cancer by the retropubic approach, a longitudinal lower abdominal incision is made, and pushing down the bladder, the treatment cone is inserted to the prostate. We performed lymph-adenectomy at the same operation, if hard and large lymph-nodes were touched. Of 30 patients, 2 had stage B disease, 10 had stage C and 18 had stage D disease. The overall 5-year survival rate (Kaplan-Meier method) after IORT was 42.6% where as that the 31 cases seen (stage C: 6 cases, stage D: 25 cases) since the Center was founded (October 1975) until the introduction of IORT was 3.2%. Although no definite conclusion can be drawn because all cases received multidisciplinary therapy, IORT appears useful for the treatment of carcinoma of the prostate.