Locally advanced prostatic cancer: long-term toxicity outcome after three-dimensional conformal radiation therapy--a dose-escalation study.
Locally advanced prostatic cancer: long-term toxicity outcome after three-dimensional conformal radiation therapy--a dose-escalation study.
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局部晚期前列腺癌：三维适形放射治疗后的长期毒性结果——剂量递增研究。
DOI：
10.1148/radiology.209.1.9769828
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发表时间：
1998
期刊：
影响因子：
--
通讯作者：
Leibel,SA
中科院分区：
文献类型：
--
作者：
Zelefsky,MJ;Fuks,Z;Wolfe,T;Kutcher,GJ;Burman,C;Ling,CC;Venkatraman,ES;Leibel,SA
目的 在 T2c-T3 期前列腺癌患者的剂量递增研究中确定 75.6 和 81.0 Gy 剂量的三维适形放射治疗的长期效果。材料和方法 50 名患者接受初始 75.6 Gy 剂量，随后 46 名患者的剂量升级至 81.0 Gy。中位随访时间分别为 60 个月和 40 个月。 结果 两种剂量水平的治疗过程中急性毒性效应发生率相似。在 96 名患者中，需要药物缓解急性症状的 2 级发病率：直肠疾病为 17%（16 名患者），泌尿道疾病为 36%（35 名患者）。所有其他患者都没有发病或没有 1 级发病。 14 名患者 (15%) 出现晚期 2 级直肠疾病。接受 75.6 Gy 的患者与接受 81.0 Gy 的患者的 5 年晚期 2 级直肠或泌尿道疾病的精算率没有差异。一名接受 81.0 Gy 治疗的患者出现了 3 级尿道狭窄，通过扩张得以解决。结论：当采用三维适形放射治疗时，肿瘤剂量增加超出局部前列腺癌的常规放射剂量是可行的，并且正常组织的发病率不会增加。
PURPOSETo determine the long-term effects of 75.6- and 81.0-Gy doses of three-dimensional conformal radiation therapy in a dose-escalation study in patients with stage T2c-T3 prostatic cancer.MATERIALS AND METHODSFifty patients received an initial 75.6-Gy dose, and the dose in 46 patients was subsequently escalated to 81.0-Gy. Median follow-up was 60 and 40 months, respectively.RESULTSThe rates of effects of acute toxicity during the course of treatment were similar for both dose levels. Among the 96 patients, the rate of grade 2 morbidities necessitating medication to relieve acute symptoms was 17% (16 patients) for rectal and 36% (35 patients) for urinary morbidities. All other patients had either no or grade 1 morbidities. Fourteen patients (15%) developed late grade 2 rectal morbidities. There were no differences in 5-year actuarial rates of late grade 2 rectal or urinary morbidities among patients who received 75.6 Gy versus those who received 81.0 Gy. One patient treated with 81.0 Gy developed a grade 3 urethral stricture, which was resolved with dilatation.CONCLUSIONTumor dose escalation beyond conventional radiation doses for localized prostatic cancer is feasible when delivered with three-dimensional conformal radiation therapy, with no increase in morbidity in normal tissue.