Correlation between the changes in the EPIC QOL scores and the dose-volume histogram parameters in high-dose-rate brachytherapy combined with hypofractionated external beam radiation therapy for prostate cancer
Correlation between the changes in the EPIC QOL scores and the dose-volume histogram parameters in high-dose-rate brachytherapy combined with hypofractionated external beam radiation therapy for prostate cancer
复制标题
高剂量率近距离放射治疗联合大分割外照射治疗前列腺癌EPIC QOL评分变化与剂量体积直方图参数的相关性
DOI：
10.1093/jjco/hyu173
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Mitsuhashi N.
中科院分区：
文献类型：
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作者：
4.Hashimoto Y;Akimoto T;Iizuka J;Tanabe K;Mitsuhashi N.
目的探讨高剂量率近距离照射联合低分割外照射治疗局限性前列腺癌患者生活质量评分变化与剂量-体积直方图参数的相关性。方法前瞻性分析118例连续118例接受高剂量率近距离照射联合低分割外照射治疗的患者的随访资料。采用扩展前列腺癌综合指数评估患者的疾病特异性生活质量，并根据放射治疗肿瘤学小组和欧洲癌症研究与治疗组织的毒性标准对急性泌尿生殖系统毒性进行分级。结果中位随访时间58个月(42-84个月)。13例患者(11%)出现2级或更严重的急性泌尿生殖系统毒性。高剂量率近距离放射治疗后1个月一般尿域前列腺癌指数综合生活质量评分明显下降，3个月后恢复至基线水平。在剂量-体积直方图参数中，V150或尿路D10的剂量学参数在高剂量率范围内的患者在12个月后一般尿区及其子量表的扩展前列腺癌指数综合生活质量评分的下降幅度明显大于这些剂量学参数在低剂量范围内的患者。结论前列腺癌高剂量区(V150或D10)可能长期影响尿域及其子量表的生活质量评分。
ObjectiveTo evaluate the correlations between the changes in the quality-of-life scores and the dose–volume histogram parameters in patients receiving high-dose-rate brachytherapy combined with hypofractionated external beam radiation therapy for localized prostate cancer.MethodsAmong the patients who were treated with high-dose-rate brachytherapy (18 Gy in two fractions) combined with hypofractionated external beam radiation therapy (45 Gy in 15 fractions), the data of 118 consecutive patients followed up for >24 months were prospectively analyzed. The disease-specific quality of life was assessed using the expanded prostate cancer index composite, and the acute genitourinary toxicities were graded based on the Radiation Therapy Oncology Group and European Organization for Research and Treatment of Cancer Toxicity criteria.ResultsThe median follow-up duration was 58 months (42–84 months). Thirteen patients (11%) developed Grade 2 or more severe acute genitourinary toxicities. The score for the general urinary domain of the expanded prostate cancer index composite quality-of-life scores dropped significantly at 1 month after high-dose-rate brachytherapy, and then returned to the baseline level by 3 months. Among the dose–volume histogram parameters, the reduction of the expanded prostate cancer index composite quality-of-life scores for the general urinary domain and its subscales at 12 months after high-dose-rate brachytherapy was significantly greater in the patients for whom the V150 or urethral D10 was within the upper 20% of the range than in those in whom the values of these dosimetric parameters were within the lower 20% of the range.ConclusionThe high-dose area of the prostate gland (V150) or urethra (D10) might influence the quality-of-life scores for the urinary domain and its subscales over the long term.