STEREOTACTIC BODY RADIOTHERAPY AS MONOTHERAPY OR POST-EXTERNAL BEAM RADIOTHERAPY BOOST FOR PROSTATE CANCER: TECHNIQUE, EARLY TOXICITY, AND PSA RESPONSE
STEREOTACTIC BODY RADIOTHERAPY AS MONOTHERAPY OR POST-EXTERNAL BEAM RADIOTHERAPY BOOST FOR PROSTATE CANCER: TECHNIQUE, EARLY TOXICITY, AND PSA RESPONSE
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DOI：
10.1016/j.ijrobp.2010.10.026
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发表时间：
2012-01-01
影响因子：
7
通讯作者：
Gottschalk, Alexander R.
中科院分区：
文献类型：
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作者：
Jabbari, Siavash;Weinberg, Vivian K.;Gottschalk, Alexander R.
目的：高剂量率（HDR）近距离放射治疗已被确定为前列腺癌（PCa）的一种优秀的单药治疗或外束放射治疗（EBRT）加强治疗后。最近，剂量学研究表明，与HDR近距离放射治疗相比，立体定向体部放射治疗（SBRT）具有实现类似剂量学的潜力。在这里，我们报告我们的技术，PSA的最低点，急性和晚期毒性SBRT作为单一疗法和后EBRT增强PCa使用HDR brachytherapy fractionation.Patients和方法：迄今为止，38例患者已与SBRT在加州大学旧金山弗朗西斯科的最低随访12个月。38例患者中有20例接受SBRT单药治疗（9.5戈伊x 4次），18例在EBRT和雄激素剥夺治疗后接受SBRT加强治疗（9.5戈伊x 2次）。PSA最低点到目前为止，44 HDR近距离放射治疗加强患者的疾病特征类似SBRT加强队列进行了分析作为一个描述性comparation.Results：SBRT耐受性良好。中位随访时间为18.3个月（范围：12.6-43.5），分别有42%和11%的患者发生了2级急性胃-泌尿系统和胃肠道毒性，迄今为止未发生3级或以上急性毒性。2例患者发生晚期3级GU毒性。迄今为止，所有患者都没有生化或临床进展的证据，并且已经观察到有利的低PSA最低点，当前的中位PSA最低点为0.35 ng/mL（范围，
Purpose: High dose rate (HDR) brachytherapy has been established as an excellent monotherapy or after external-beam radiotherapy (EBRT) boost treatment for prostate cancer (PCa). Recently, dosimetric studies have demonstrated the potential for achieving similar dosimetry with stereotactic body radiotherapy (SBRT) compared with HDR brachytherapy. Here, we report our technique, PSA nadir, and acute and late toxicity with SBRT as monotherapy and post-EBRT boost for PCa using HDR brachytherapy fractionation.Patients and Methods: To date, 38 patients have been treated with SBRT at the University of California-San Francisco with a minimum follow-up of 12 months. Twenty of 38 patients were treated with SBRT monotherapy (9.5 Gy x 4 fractions), and 18 were treated with SBRT boost (9.5 Gy x 2 fractions) post-EBRT and androgen deprivation therapy. PSA nadir to date for 44 HDR brachytherapy boost patients with disease characteristics similar to the SBRT boost cohort was also analyzed as a descriptive comparison.Results: SBRT was well tolerated. With a median follow-up of 18.3 months (range, 12.6-43.5), 42% and 11% of patients had acute Grade 2 gastrourinary and gastrointestinal toxicity, respectively, with no Grade 3 or higher acute toxicity to date. Two patients experienced late Grade 3 GU toxicity. All patients are without evidence of biochemical or clinical progression to date, and favorably low PSA nadirs have been observed with a current median PSA nadir of 0.35 ng/mL (range,