RESUMO
We present a retrospective study to evaluate the outcome of postoperative radiotherapy for biochemical or clinical recurrent prostate cancer. Twenty-six patients (median age 60 years) underwent radiotherapy after radical prostatectomy between January 1997 and January 2004. Seven patients received adjuvant radiotherapy and 19 received salvage radiotherapy. The median prostate-specific antigen at diagnosis was 8.6 (0.9-89) and most (23 patients) presented with T(3)N(0) disease. The median follow up was 19.5 months (5-84 months). All patients received a dose of 61.2 Gy at 1.8 Gy per fraction, 20 initially receiving 45 Gy to the lesser pelvis. The median dose to the bladder, rectum and left femoral head were 55.6, 57.5 and 33.8 Gy, respectively. All patients were managed radiotherapeutically by the first author. Twenty-four patients are alive. Two patients have died, one from oesophageal cancer and the second from metastatic prostate cancer. Two other patients also developed metastatic disease. Four asymptomatic patients with a rising prostate-specific antigen are under observation. None of the 26 patients has developed a local recurrence. Seven patients have developed grade 1 late bowel effects and three a grade 2 late effect. Eight patients suffer from grade 1 late genitourinary effects and two from grade 2 effects. One patient developed impotence, whereas 23 patients were rendered impotent postoperatively. There were no grade 3/4 late effects. Postoperative radiotherapy is well tolerated and provides effective local control.
Assuntos
Cuidados Pós-Operatórios/métodos , Prostatectomia , Neoplasias da Próstata/radioterapia , Idoso , Austrália , Relação Dose-Resposta à Radiação , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/radioterapia , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/cirurgia , Doses de Radiação , Estudos Retrospectivos , Terapia de Salvação/métodos , Análise de Sobrevida , Resultado do TratamentoRESUMO
In 1969 and 1973, 598 and 474 randomly selected students at a large midwestern university reported their present and past use, and extent of use of substances taken without medical prescription. Ten of the 18 substances showed a significant increase in percentage of users over time with greatest increases for marijuana, hashish, and alcohol. These three plus tobacco are those substances most used by students and used most frequently. Other substances are used by less than 7 per cent presently and by less than 4 per cent on an often or regular basis. The percentage of tobacco users has not diminished, but smokers report lower frequencies of use in 1973. Single undergraduates reported highest percentage of substance users, and sex differences were not evident. Methodological issues in survey research on substance use are discussed as well as implications for substance educational programming.