Ultrahypofractionated Radiotherapy versus Conventional to Moderate Hypofractionated Radiotherapy for Clinically Localized Prostate Cancer.
Ultrahypofractionated Radiotherapy versus Conventional to Moderate Hypofractionated Radiotherapy for Clinically Localized Prostate Cancer.
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DOI：
10.3390/cancers14010195
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发表时间：
2021-12-31
期刊：
影响因子：
5.2
通讯作者：
Okabe H
中科院分区：
文献类型：
--
作者：
Yamazaki H;Suzuki G;Aibe N;Shimizu D;Kimoto T;Masui K;Yoshida K;Nakamura S;Hashimoto Y;Okabe H
最近，缩短治疗时间变得更加重要。超低分割放射治疗 (UHF) 治疗局限性前列腺癌是一种令人着迷的治疗策略。然而，超高频放射治疗期间均衡、最佳剂量的概念仍然是一个有争议的策略，目前只有少数关于超高频的研究报道。我们必须等待几年后的随机试验结果。因此，我们试图揭示迄今为止与传统至中度大分割放疗相比可接受的时间表。我们发现使用 EQD2 ≤ 100 Gy1.5 的 UHF 是一种可行的 UHF 方案，在毒性和疗效之间具有良好的平衡。本研究的目的是比较超大分割放疗（UHF）和剂量递增的常规至中度大分割放疗（DeRT）对临床局限性前列腺癌的毒性（第一终点）和疗效（第二终点）。我们使用多机构回顾性数据比较了 253 名接受 UHF 治疗的患者和 499 名接受 DeRT 治疗的患者。为了分析毒性，我们将UHF分为高剂量UHF（H-UHF；每次分次2 Gy的等效剂量：EQD2 > 100 Gy1.5）和低剂量UHF（L-UHF；EQD2 ≤ 100 Gy1.5）。在毒性方面，H-UHF升高3年累积晚期胃肠道和泌尿生殖毒性等级≥2级（11.1％和9.3％），多于L-UHF（3％和1.2％）和DeRT（3.1％和4.8％，p = 0.00126和p = 0.00549）。中位随访时间为32.0和61.7个月，精算3年生化无失败生存率在低风险组中分别为100%（L-UHF和H-UHF为100%和100%）和96.3%，中风险组为96.5%（97.1%和95.6%）和94.9%， UHF 组和 DeRT 组中高危组的发生率分别为 93.7%（100% 和 94.6%）和 91.7%。 UHF 的疗效尚不明确，虽然不是结论性的，但由于 UHF 的随访时间较短，因此具有启发性。使用 EQD2 ≤ 100 Gy1.5 的 L-UHF 是一种可行的 UHF 方案，在毒性和疗效之间具有良好的平衡。
Recently, shortening treatment time is becoming more important. Ultrahypofractionated radiotherapy (UHF) for localized prostate cancer is a fascinating treatment strategy; however, the concept of a well-balanced, optimal dose during UHF radiotherapy remains a contentious strategy, with only a few studies on UHF already reported. We must wait for the results of randomized trials several years away. Therefore, we tried to reveal the acceptable schedule in comparison to conventional to moderate hypofractionated radiotherapy so far. We found that UHF using EQD2 ≤ 100 Gy1.5 is a feasible UHF schedule with a good balance between toxicity and efficacy. The purpose of this study was to compare the toxicity (first endpoint) and efficacy (second endpoint) of ultrahypofractionated radiotherapy (UHF) and dose-escalated conventional to moderate hypofractionated radiotherapy (DeRT) for clinically localized prostate cancer. We compared 253 patients treated with UHF and 499 patients treated with DeRT using multi-institutional retrospective data. To analyze toxicity, we divided UHF into High-dose UHF (H-UHF; equivalent doses of 2 Gy per fraction: EQD2 > 100 Gy1.5) and low-dose UHF (L-UHF; EQD2 ≤ 100 Gy1.5). In toxicity, H-UHF elevated for 3 years accumulated late gastrointestinal and genitourinary toxicity grade ≥ 2 (11.1% and 9.3%) more than L-UHF (3% and 1.2%) and DeRT (3.1% and 4.8%, p = 0.00126 and p = 0.00549). With median follow-up periods of 32.0 and 61.7 months, the actuarial 3-year biochemical failure-free survival rates were 100% (100% and 100% in the L-UHF and H-UHF) and 96.3% in the low-risk group, 96.5% (97.1% and 95.6%) and 94.9% in the intermediate-risk group, and 93.7% (100% and 94.6%) and 91.7% in the high-risk group in the UHF and DeRT groups, respectively. UHF showed equivocal efficacy, although not conclusive but suggestive due to a short follow-up period of UHF. L-UHF using EQD2 ≤ 100 Gy1.5 is a feasible UHF schedule with a good balance between toxicity and efficacy.
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影响因子：
4.6
作者：
Ishiyama H;Tsumura H;Nagano H;Watanabe M;Mizuno E;Taka M;Kobayashi H;Eriguchi T;Imada H;Inaba K;Nakamura K
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