Preliminary result of carbon-ion radiotherapy using the spot scanning method for prostate cancer
Preliminary result of carbon-ion radiotherapy using the spot scanning method for prostate cancer
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DOI：
10.1186/s13014-020-01575-7
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发表时间：
2020-05-27
影响因子：
3.6
通讯作者：
Kamada, Tadashi
中科院分区：
文献类型：
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作者：
Takakusagi, Yosuke;Katoh, Hiroyuki;Kamada, Tadashi
背景2015年，神奈川癌症中心启动了前列腺癌的碳离子放射治疗（CIRT）。本研究分析了CIRT治疗前列腺癌的初步临床结果。方法回顾性分析2015年12月至2017年12月253例前列腺癌患者采用点扫法行CIRT治疗的临床结局。辐照剂量设定为51.6戈伊（相对生物学有效性），在3周内分12次递送。使用Phoenix定义来定义生化复发。根据CTCAE第4.0版评估毒性。结果：患者年龄中位数为70（47-86）岁。中位随访时间为35.3（4.1-52.9）个月。根据D 'Amico分类系统，分别有8例、88例和157例患者被分类为低、中和高风险。244例患者接受了雄激素剥夺治疗。低、中和高风险组3年时的生化无复发率分别为87.5%、88.0%和97.5%（P = 0.036）。在12例（4.7%）患者中观察到2级急性泌尿系统毒性。未观察到2级急性直肠毒性。分别在17例（6.7%）和3例（1.2%）患者中观察到2级晚期泌尿毒性和2级晚期直肠毒性。单变量分析显示，既往经尿道前列腺切除术与晚期2级毒性显著相关。未检测到晚期直肠毒性的预测因子。结论采用点扫法行CIRT治疗前列腺癌疗效良好。
Background Carbon-ion radiotherapy (CIRT) for prostate cancer was initiated at Kanagawa Cancer Center in 2015. The present study analyzed the preliminary clinical outcomes of CIRT for prostate cancer. Methods The clinical outcomes of 253 patients with prostate cancer who were treated with CIRT delivered using the spot scanning method between December 2015 and December 2017 were retrospectively analyzed. The irradiation dose was set at 51.6 Gy (relative biological effectiveness) delivered in 12 fractions over 3 weeks. Biochemical relapse was defined using the Phoenix definition. Toxicities were assessed according to CTCAE version 4.0. Results: The median patient age was 70 (47-86) years. The median follow-up duration was 35.3 (4.1-52.9) months. According to the D'Amico classification system, 8, 88, and 157 patients were classified as having low, intermediate, and high risks, respectively. Androgen deprivation therapy was administered in 244 patients. The biochemical relapse-free rate in the low-, intermediate-, and high-risk groups at 3 years was 87.5, 88.0, and 97.5%, respectively (P = 0.036). Grade 2 acute urinary toxicity was observed in 12 (4.7%) patients. Grade 2 acute rectal toxicity was not observed. Grade 2 late urinary toxicity and grade 2 late rectal toxicity were observed in 17 (6.7%) and 3 patients (1.2%), respectively. Previous transurethral resection of the prostate was significantly associated with late grade 2 toxicity in univariate analysis. The predictive factor for late rectal toxicity was not detected. Conclusion The present study demonstrated that CIRT using the spot scanning method for prostate cancer produces favorable outcomes.