Acute and late complications after hypofractionated intensity modulated radiotherapy in prostate cancer
Acute and late complications after hypofractionated intensity modulated radiotherapy in prostate cancer
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DOI：
10.1007/s11604-017-0630-2
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发表时间：
2017-05-01
影响因子：
2.1
通讯作者：
Oguchi, Masahiko
中科院分区：
文献类型：
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作者：
Kozuka, Takuyo;Nakano, Masahiro;Oguchi, Masahiko
目的：本研究比较前列腺癌低分次调强放疗（hypofractional intensity regulation radiation therapy，简称hypoimrt）与常规分次调强放疗（convi -IMRT）的并发症。材料和方法：hypoimrt分28次释放70 Gy，而convimrt分39次释放78 Gy。根据不良事件通用术语标准4.0版对两组患者的毒性进行分级，分别是放疗期间每周、放疗后1个月和每年。结果：低剂量imrt组患者的中位随访时间分别为39.1个月和38.7个月。急性和晚期不良事件发生率无显著差异。2级急性泌尿生殖系统并发症的比例在低剂量组和低剂量组分别为48.4%和51.2%。基线国际前列腺症状评分（IPSS）为10或10以上是2级急性泌尿生殖系统毒性的唯一重要预后因素。2级晚期直肠出血3年发生率在低剂量和低剂量imrt组分别为3.2%和3.5%。直肠体积小与2级晚期直肠出血显著相关。结论对于前列腺癌的急性和晚期不良事件，低分割IMRT具有良好的耐受性，与常规分割IMRT相当。
Purpose The present study compared the complications associated with hypofractionated intensity-modulated radiation therapy (Hypo-IMRT) of prostate cancer to conventionally fractionated IMRT (Conv-IMRT).Materials and methods Hypo-IMRT delivered 70 Gy in 28 fractions, whereas Conv-IMRT delivered 78 Gy in 39 fractions. Toxicity was graded with the Common Terminology Criteria for Adverse Events, version 4.0, weekly during radiotherapy, 1 month after radiotherapy, and annually in both patient groups.Results The median follow-ups were 39.1 and 38.7 months for patients in the Hypo-and Conv-IMRT groups, respectively. There was no significant difference in rates of acute and late adverse events. The proportions of grade 2 acute genitourinary complications were 48.4 and 51.2% in the Hypo-and Conv-IMRT groups, respectively. The presence of a baseline International Prostate Symptom Score (IPSS) of ten or more was the only significant prognostic factor for grade 2 acute genitourinary toxicity. The incidence of grade 2 late rectal hemorrhage at 3 years was 3.2 and 3.5% in the Hypo-and Conv-IMRT groups, respectively. Small rectal volume was significantly associated with grade 2 late rectal hemorrhage.Conclusion Regarding acute and late adverse events, hypofractionated IMRT for prostate cancer was well tolerated and comparable with conventionally fractionated IMRT.