HUMAN COLLAGEN INJECTIONS TO REDUCE RECTAL DOSE DURING RADIOTHERAPY
HUMAN COLLAGEN INJECTIONS TO REDUCE RECTAL DOSE DURING RADIOTHERAPY
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DOI：
10.1016/j.ijrobp.2011.02.034
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发表时间：
2012-04-01
影响因子：
7
通讯作者：
Schultz, Steven E.
中科院分区：
文献类型：
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作者：
Noyes, William R.;Hosford, Charles C.;Schultz, Steven E.
目的：持续寻找干预措施，解决与前列腺癌放射治疗相关的直肠毒性的发生率和等级，是一个主要问题。我们正在报告一项调查性试验，使用人类胶原蛋白，以增加前列腺和直肠前壁之间的距离，从而降低辐射剂量到recton.Methods：这是一个试点研究评估使用人类胶原蛋白作为替代剂的直肠壁注射前开始一个过程中的调强放疗（IMRT）前列腺癌。使用经会阴途径，在门诊环境中将20 mL人胶原蛋白注射到直肠周围间隙中。计算机化调强放射治疗计划进行前和后胶原注射，并在患者完成放疗后，以确定辐射剂量减少与胶原注射直肠。在完成放射治疗后6个月和12个月进行计算机断层扫描，以评估胶原蛋白的吸收率。所有患者均接受前列腺调强放射治疗，剂量为75.6戈伊。在门诊环境中注射人胶原蛋白耐受性良好。前列腺和直肠前壁之间的平均间隔为12.7 mm。直肠前壁的剂量平均减少50%。所有男性否认任何直肠症状在study.Conclusions：经会阴注射的人胶原蛋白的目的是组织位移是耐受性良好的门诊设置。前列腺和直肠之间的分离增加导致在接受IMRT时直肠的辐射剂量显著降低，并且与直肠毒性无关。(c)2012 Elsevier Inc.
Objectives: The continuing search for interventions, which address the incidence and grade of rectal toxicities associated with radiation treatment of prostate cancer, is a major concern. We are reporting an investigational trial using human collagen to increase the distance between the prostate and anterior rectal wall, thereby decreasing the radiation dose to the rectum.Methods: This is a pilot study evaluating the use of human collagen as a displacing agent for the rectal wall injected before starting a course of intensity-modulated radiotherapy (IMRT) for prostate cancer. Using a transperineal approach, 20 mL of human collagen was injected into the perirectal space in an outpatient setting. Computerized IMRT plans were performed pre- and postcollagen injection, and after a patient completed their radiotherapy, to determine radiation dose reduction to the rectum associated with the collagen injection. Computed tomography scans were performed 6 months and 12 months after completing their radiotherapy to evaluate absorption rate of the collagen. All patients were treated with IMRT to a dose of 75.6 Gy to the prostate.Results: Eleven patients were enrolled into the study. The injection of human collagen in the outpatient setting was well tolerated. The mean separation between the prostate and anterior rectum was 12.7 mm. The mean reduction in dose to the anterior rectal wall was 50%. All men denied any rectal symptoms during the study.Conclusions: The transperineal injection of human collagen for the purpose of tissue displacement is well tolerated in the outpatient setting. The increased separation between the prostate and rectum resulted in a significant decrease in radiation dose to the rectum while receiving IMRT and was associated with no rectal toxicities. (c) 2012 Elsevier Inc.