目的:本研究以回溯性分析法來評估攝護腺癌病人接受全程放射治療後短期預後及不同預後因子。

材料與方法:從1994年到2001年期間共有67位攝護腺癌病人於和信治癌中心醫院接受全程放射治療，合併或未合併放射線前或放射線後輔助性荷爾蒙治療。本研究不包含姑息性放射治療及開刀後輔助性放射治療。但有一位的歲的病人因有第三度腸胃道併發症中斷治療而不納入分析。對骨盆腔或儲精囊及攝護腺的劑量中位值為46Gy ，以每天一次，每次1.8-2.0Gy治療， 對攝護腺的劑量中位值為70Gy 0 49位病人接受輔助性荷爾蒙治療，通常在放射治療前1-3個 月前開始使用。利用Kaplan-Meier方式計算存活曲線，以Log-ranktest來計算不同預後因子對 存活曲線的影響。

結果:共有66位病人進入分析，追蹤時間的中位值為三十六個月，以單一變項方式，僅在Gleason score小於8及大於等於8的病人間，有明顯統計學上的差別意義。其他不同預後因子 無統計學上的意義。三年的整體存活率、無病存活率及無生化復發存活率在Gleasonscore 小於8及大於等於8的病人中，分別為97%和55% ' 97%和27% ' 97%和35% (p < 0.0001)。在 T2-T4的病人中接受合併放射治療與輔助性荷爾蒙治療的三年整體存活率、無病存活率及無生

化復發存活率為869%、78%及809%。

結論:本研究中攝護腺癌接受放射治療的病人並未具有統計意義的預後因子，除僅在Gleasonscore上發現統計學上的意義。未來我們需要更多的病人和更長的追蹤時間來探討可能的預後因 子及確定的治療結果。

Purpose:This study is a retrospective analysis to evaluate the short-term outcome and prognostic factors of patients with prostatic adenocarcinoma and receiving definitive radiotherapy (RT)

Methods and Materials : From 1994 through 2001， 67 patients with adenocarcinoma of prostate underwent definitive RT with or without neoadjuvant hormone therapy or adjuvant hormone therapy at Koo Foundation Sun Yat-Sen Cancer Center， Taipei， Taiwan， One 83-year-old patient was excluded for the grade 3 gastrointestinal toxicity and incomplete RT. The median dose to whole pelvis or seminal vesicle/prostate was 46 Gy in a daily fraction of 1，8-2，0 Gy， The median dose to the prostate was 70 Gy， The neoadjuvant hormone the rapγwas given to 49 patients， usually starting 1- 3 months before the initial date of RT. The survival outcome was estimated by Kaplan-Meier method， The analysis of prognostic factors on survival was calculated by Log-rank test.

Results: The median follow-up interval of 66 patients was 36 months. The univariate analysis of overall survival， disease-free survival and biochemical failure-free survival showed only Gleason score with statistical significance. The 3-year overall survival， disease-free survival and biochemical failure-free survival were 97 % and 55%， 97 % and 27%， and 97 % and 35% in p叫ients with Gleason Score < 8 and Gleason Score三8， respectively (p<0.0001 for each comparison). The 3-year overall survival， disease-free survival and biochemical failure-free survival were 86%， 78%， and 80%， respectively， in patients with stage T2-T4 disease and receiving neoadjuvant hormone therapy followed by definitive RT. Treatment-related acute and late toxicity were all less than or equal to grade 2.

Conclusion: For our patients with adenocarcinoma of prostate undergoing definitive RT and short-term follow-up， we found no statistically significant difference in T stage， nodal status and pretreatment PSA level， except the significance in Gleason score. Our outcome of patients who received RT and neoadjuvant hormone therapγindicated the acceptable quality of care in our department. The larger series with long-term follow-up is needed to further delineate the prognostic factors and confirmed outcome.