Analysis of late toxicity associated with external beam radiation therapy for prostate cancer with uniform setting of classical 4-field 70 Gy in 35 fractions: a survey study by the Osaka Urological Tumor Radiotherapy Study Group.
Analysis of late toxicity associated with external beam radiation therapy for prostate cancer with uniform setting of classical 4-field 70 Gy in 35 fractions: a survey study by the Osaka Urological Tumor Radiotherapy Study Group.
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DOI：
10.1093/jrr/rrs083
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发表时间：
2013-01
影响因子：
2
通讯作者：
Ogawa K
中科院分区：
文献类型：
--
作者：
Yoshioka Y;Suzuki O;Nishimura K;Inoue H;Hara T;Yoshida K;Imai A;Tsujimura A;Nonomura N;Ogawa K
我们旨在使用均匀剂量分割和射束排列来分析前列腺癌体外放射治疗(EBRT)相关的晚期毒性，重点是3D(CT)模拟和射野大小的影响。我们收集了1998至2006年间在日本大阪的五个机构接受EBRT治疗的局限性前列腺癌患者的数据。所有患者均接受了35次70Gy机架角分别为0°、90°、180°和270°的经典四野照射。晚期毒性严格按照4.0版不良事件通用术语标准进行评估。总共分析了362名患者，平均随访时间为4.5年(范围为1.0-11.6年)。5年总存活率为93%，特定病因存活率为96%。左右、上、下、前后方向门静脉平均视野大小2D分别为10.8±1.1、10.2±1.0和8.8±0.9 cm，3D分别为8.4±1.2、8.2±1.0和7.7±1.0 cm(P<；0.001)。未观察到4级或5级晚期毒性反应。精算的5年2-3级泌尿生殖系统和胃肠道(GI)晚期毒性发生率分别为6%和14%，而相应的晚期直肠出血发生率2D模拟为23%，3D模拟为7%(P<；0.001)。在经典的4野70Gy35次的均匀设置下，CT模拟的使用和由此导致的门脉野大小的减少显著地与减少晚期胃肠道毒性有关，尤其是在减少直肠出血的情况下。
We aimed to analyse late toxicity associated with external beam radiation therapy (EBRT) for prostate cancer using uniform dose-fractionation and beam arrangement, with the focus on the effect of 3D (CT) simulation and portal field size. We collected data concerning patients with localized prostate adenocarcinoma who had been treated with EBRT at five institutions in Osaka, Japan, between 1998 and 2006. All had been treated with 70 Gy in 35 fractions, using the classical 4-field technique with gantry angles of 0°, 90°, 180° and 270°. Late toxicity was evaluated strictly in terms of the Common Terminology Criteria for Adverse Events Version 4.0. In total, 362 patients were analysed, with a median follow-up of 4.5 years (range 1.0–11.6). The 5-year overall and cause-specific survival rates were 93% and 96%, respectively. The mean ± SD portal field size in the right–left, superior–inferior, and anterior–posterior directions was, respectively, 10.8 ± 1.1, 10.2 ± 1.0 and 8.8 ± 0.9 cm for 2D simulation, and 8.4 ± 1.2, 8.2 ± 1.0 and 7.7 ± 1.0 cm for 3D simulation (P < 0.001). No Grade 4 or 5 late toxicity was observed. The actuarial 5-year Grade 2–3 genitourinary and gastrointestinal (GI) late toxicity rates were 6% and 14%, respectively, while the corresponding late rectal bleeding rate was 23% for 2D simulation and 7% for 3D simulation (P < 0.001). With a uniform setting of classical 4-field 70 Gy/35 fractions, the use of CT simulation and the resultant reduction in portal field size were significantly associated with reduced late GI toxicity, especially with less rectal bleeding.
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影响因子：
2
作者：
Ogino, Ichiro;Kaneko, Tetsuji;Morita, Satoshi
通讯作者：
Morita, Satoshi
DOI：
10.1016/0360-3016(87)90038-1
发表时间：
1987-07-01
影响因子：
7
作者：
PILEPICH, MV;ASBELL, SO;PIDCOCK, GM
通讯作者：
PIDCOCK, GM
影响因子：
8.8
作者：
Dearnaley, DP;Hall, E;Lawrence, D;Huddart, RA;Eeles, R;Nutting, CM;Gadd, J;Warrington, A;Bidmead, M;Horwich, A
通讯作者：
Horwich, A
影响因子：
3.1
作者：
Yoshioka, Yasuo;Suzuki, Osamu;Inoue, Takehiro
通讯作者：
Inoue, Takehiro
影响因子：
168.9
作者：
Dearnaley, DP;Khoo, VS;Horwich, A
通讯作者：
Horwich, A