Intensity-modulated radiation therapy for prostate cancer: Late morbidity and results on biochemical control
Intensity-modulated radiation therapy for prostate cancer: Late morbidity and results on biochemical control
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DOI：
10.1016/j.radonc.2006.12.007
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发表时间：
2007-02-01
影响因子：
5.7
通讯作者：
De Neve, Wilfried J.
中科院分区：
文献类型：
--
作者：
De Meerleer, Gert O.;Fonteyne, Valerie H.;De Neve, Wilfried J.
目的：报告前列腺癌调强放射治疗 (IMRT) 后的晚期发病率和生化无复发生存率 (bRFS)。方法：1998 年至 2005 年间，133 名 T(1-4) NO MO 前列腺癌患者接受了 IMRT 治疗。中位随访时间为 36 个月。在第一组中，患者接受的中位计划靶体积 (PTV) 剂量为 74 Gy，最大直肠剂量严格限制为 72 Gy（741172，n = 51）。后来，中位 PTV 和最大直肠剂量分别增加至 76 和 74 Gy (761174；n = 82)。我们定义了低风险 (n = 20)、中风险 (n = 70) 和高风险 (n = 43) 组。对中危和高危组的患者进行雄激素剥夺。根据 ASTRID 共识，记录了晚期胃肠道 (GI) 和泌尿生殖 (GU) 发病率以及生化复发。结果：我们观察到 2 级 GI (17%) 和 GU (19%)、3 级 GI (1%) 和 GU (3%) 晚期毒性。除血尿外，副作用的中位持续时间为 6 个月。 3 年和 5 年生化无复发生存率 (bRFS) 分别为 88% 和 83%，761174 组的 3 年 bRSF 显着优于 741172 组 (p = 0.01)。低风险、中风险和高风险组患者的五年 bRFS 分别为 100%、94% 和 74% (p < 0.01)。结论：IMRT 治疗局限性或局部晚期前列腺癌的发病率低，生化控制良好。 (c) 2006 Elsevier Ireland Ltd. 保留所有权利。
Purpose: To report on late morbidity and biochemical relapse-free survival (bRFS) after intensity-modulated radiation therapy (IMRT) for prostate cancer.Methods: Between 1998 and 2005 133 patients were treated with IMRT for T(1-4) NO MO prostate cancer. The median follow-up time was 36 months. In a first cohort, patients received a median planning target volume (PTV) dose of 74 Gy with a hard constraint on maximum rectum dose of 72 Gy (741172, n = 51). Later, median PTV and maximum rectum dose were increased to 76 and 74 Gy, respectively (761174; n = 82). We defined low-risk (n = 20), intermediate-risk (n = 70) and high-risk (n = 43) groups. Androgen deprivation was given to patients in the intermediate- and high-risk group. Late gastro-intestinal (GI) and genito-urinary (GU) morbidity and biochemical relapse, in accordance with the ASTRID consensus, were recorded.Results: We observed grade 2 GI (17%) and GU (19%), grade 3 GI (1%) and GU (3%) late toxicities. Except for hematuria, the median duration of side-effects was 6 months. Biochemical relapse-free survival (bRFS) at 3 and 5 years was 88% and 83%, respectively, with a significantly better 3-year bRSF for the 761174 than for the 741172 group (p = 0.01). Five-year bRFS for patients in the low-risk, intermediate-risk and high-risk group was 100%, 94% and 74%, respectively (p < 0.01).Conclusion: IMRT for localized or locally advanced prostate cancer combines low morbidity with excellent biochemical control. (c) 2006 Elsevier Ireland Ltd. ALL rights reserved.