Low incidence of new biochemical and clinical hypogonadism following hypofractionated stereotactic body radiation therapy (SBRT) monotherapy for low- to intermediate-risk prostate cancer.
Low incidence of new biochemical and clinical hypogonadism following hypofractionated stereotactic body radiation therapy (SBRT) monotherapy for low- to intermediate-risk prostate cancer.
复制标题
DOI：
10.1186/1756-8722-4-12
复制
发表时间：
2011-03-27
影响因子：
28.5
通讯作者：
Collins SP
中科院分区：
文献类型：
--
作者：
Oermann EK;Suy S;Hanscom HN;Kim JS;Lei S;Yu X;Zhang G;Ennis B;Rohan JP;Piel N;Sherer BA;Borum D;Chen VJ;Batipps GP;Constantinople NL;Dejter SW;Bandi G;Pahira J;McGeagh KG;Adams-Campbell L;Jha R;Dawson NA;Collins BT;Dritschilo A;Lynch JH;Collins SP
射波刀是一种很有吸引力的低分割立体定向身体放射治疗（SBRT）的输送系统，因为它能够向移动目标提供高度适形的放射治疗。这种一致性是通过100次非共面辐射光束实现的，这可能会增加短暂性睾丸照射，导致治疗后性腺功能减退。我们报告了我们使用射波刀SBRT治疗低至中危前列腺癌患者的早期经验，并评估了诱导生化和临床性腺功能减退的比率。26例患者接受5次低分割SBRT治疗，剂量为36.25 Gy。所有患者均为组织学证实的低至中危前列腺腺癌（临床分期≤T2b， Gleason评分≤7，PSA≤20 ng/ml）。治疗前、治疗后1个月及治疗后每3个月检测一次PSA和总睾酮水平，持续1年。生化性腺功能减退定义为血清总睾酮水平低于8 nmol/L。尿毒性和胃肠道毒性采用通用毒性标准v3进行评估；生活质量评估采用美国泌尿学会症状评分、男性性健康量表和前列腺癌扩展指数综合问卷。所有26例患者均完成了中位15个月（范围13-19个月）的随访。治疗前PSA中位数为5.75 ng/ml（范围为2.3-10.3 ng/ml），治疗一年后PSA中位数降至0.7 ng/ml（范围为0.2-1.8 ng/ml）。治疗前血清总睾酮水平中位数为13.81 nmol/L（范围为5.55 ~ 39.87 nmol/L）。治疗后睾酮水平缓慢下降，随访1年中位值为10.53 nmol/L，显著低于治疗前（p < 0.013）。绝对下降的中位数为3.28 nmol/L，下降的中位数百分比为23.75%。治疗后1年生化性腺功能减退未见增加。治疗一年后，平均EPIC性和激素评分无显著变化。低分割SBRT提供了大分割尺寸的放射生物学益处，并且对于患有低至中度前列腺癌的男性具有良好的耐受性。早期结果令人鼓舞，生化反应极佳。治疗后1年新生化及临床性腺功能减退率较低。
The CyberKnife is an appealing delivery system for hypofractionated stereotactic body radiation therapy (SBRT) because of its ability to deliver highly conformal radiation therapy to moving targets. This conformity is achieved via 100s of non-coplanar radiation beams, which could potentially increase transitory testicular irradiation and result in post-therapy hypogonadism. We report on our early experience with CyberKnife SBRT for low- to intermediate-risk prostate cancer patients and assess the rate of inducing biochemical and clinical hypogonadism. Twenty-six patients were treated with hypofractionated SBRT to a dose of 36.25 Gy in 5 fractions. All patients had histologically confirmed low- to intermediate-risk prostate adenocarcinoma (clinical stage ≤ T2b, Gleason score ≤ 7, PSA ≤ 20 ng/ml). PSA and total testosterone levels were obtained pre-treatment, 1 month post-treatment and every 3 months thereafter, for 1 year. Biochemical hypogonadism was defined as a total serum testosterone level below 8 nmol/L. Urinary and gastrointestinal toxicity was assessed using Common Toxicity Criteria v3; quality of life was assessed using the American Urological Association Symptom Score, Sexual Health Inventory for Men and Expanded Prostate Cancer Index Composite questionnaires. All 26 patients completed the treatment with a median 15 months (range, 13-19 months) follow-up. Median pre-treatment PSA was 5.75 ng/ml (range, 2.3-10.3 ng/ml), and a decrease to a median of 0.7 ng/ml (range, 0.2-1.8 ng/ml) was observed by one year post-treatment. The median pre-treatment total serum testosterone level was 13.81 nmol/L (range, 5.55 - 39.87 nmol/L). Post-treatment testosterone levels slowly decreased with the median value at one year follow-up of 10.53 nmol/L, significantly lower than the pre-treatment value (p < 0.013). The median absolute fall was 3.28 nmol/L and the median percent fall was 23.75%. There was no increase in biochemical hypogonadism at one year post-treatment. Average EPIC sexual and hormonal scores were not significantly changed by one year post-treatment. Hypofractionated SBRT offers the radiobiological benefit of a large fraction size and is well-tolerated by men with low- to intermediate-risk prostate cancer. Early results are encouraging with an excellent biochemical response. The rate of new biochemical and clinical hypogonadism was low one year after treatment.
登录
查看更多内容
DOI：
10.1016/j.ijrobp.2008.05.059
发表时间：
2009-03-15
影响因子：
7
作者：
King, Christopher R.;Brooks, James D.;Presti, Joseph C., Jr.
通讯作者：
Presti, Joseph C., Jr.
DOI：
10.1016/j.ijrobp.2007.10.043
发表时间：
2008-03-01
影响因子：
7
作者：
Bruheim, Kjersti;Svartberg, Johan;Guren, Marianne G.
通讯作者：
Guren, Marianne G.
影响因子：
2.8
作者：
Kilby, W.;Dooley, J. R.;Maurer, C. R., Jr.
通讯作者：
Maurer, C. R., Jr.
影响因子：
120.7
作者：
D'Amico, AV;Whittington, R;Wein, A
通讯作者：
Wein, A
影响因子：
2.1
作者：
MONATH, JR;MCCULLOUGH, DL;JAROW, JP
通讯作者：
JAROW, JP