Adverse effects of androgen deprivation therapy on persistent genitourinary complications after carbon ion radiotherapy for prostate cancer
Adverse effects of androgen deprivation therapy on persistent genitourinary complications after carbon ion radiotherapy for prostate cancer
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DOI：
10.1016/j.ijrobp.2007.12.044
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发表时间：
2008-09-01
影响因子：
7
通讯作者：
Tsujii, Hirohiko
中科院分区：
文献类型：
--
作者：
Ishikawa, Hitoshi;Tsuji, Hiroshi;Tsujii, Hirohiko
目的：确定前列腺癌碳离子放射治疗 (C-ion RT) 后持续性晚期泌尿生殖 (GU) 发病的危险因素。 方法和材料：2000 年 4 月至 2003 年 11 月期间，对 175 名前列腺癌患者进行了一项 11 期研究，以根据之前的 I-II 期研究建立的剂量分级（20 份中 66 格雷当量）评估 C-ion RT。回顾性检查了 172 名 C 离子 RT 后存活超过 18 个月的患者中临床和剂量测定参数对持续 GU 毒性发生的影响。 33 名低危患者单独进行了 C 离子放疗，139 名高危患者接受了 C 离子放疗联合雄激素剥夺治疗 (ADT)。 结果：分别有 36 名 (21%) 和 3 名 (2%) 患者出现 I 级和 2 级持续性 GU 毒性。通过多变量分析，长程 ADT（>= 24 个月）和急性 GU 毒性的使用与持续毒性的发生相关（分别为 p = 0.016 和 p = 0.048），但短程 ADT（< 24 个月）对毒性的发生没有影响（p = 0.35）。 80例接受长程ADT的患者5年精算并发症发生率为31.1%； 92 例未接受 ADT 或短程 ADT 的相应率为 22.2%。结论：本研究中观察到长程 ADT 对持续性 GU 发病率的不良影响。需要进一步研究根据危险人群确定合适的 ADT 给药方案，但非高危前列腺癌患者不宜采用长疗程 ADT 以降低 C 离子放疗的 GU 毒性率。 (C) 2008 爱思唯尔公司。
Purpose: To determine the risk factors for persistent late genitourinary (GU) morbidity after carbon ion radiotherapy (C-ion RT) for prostate cancer.Methods and Materials: Between April 2000 and November 2003, a Phase 11 study of 175 prostate cancer patients was performed to assess C-ion RT with a dose fractionation (66 Gray equivalent in 20 fractions) established from previous Phase I-II studies. The effects of the clinical and dosimetric parameters on the occurrence of persistent GU toxicity in 172 patients who survived for > 18 months after C-ion RT were examined retrospectively. C-ion RT alone was performed for 33 low-risk patients, and 139 high-risk patients received C-ion RT combined with androgen deprivation therapy (ADT).Results: Grade I and 2 persistent GU toxicities developed in 36 (21%) and 3 (2%) patients, respectively. The use of long-course ADT (>= 24 months) and acute GU toxicity were associated with the occurrence of persistent toxicity by multivariate analysis (p = 0.016 and p = 0.048, respectively), but short-course ADT (< 24 months) had no effect on the development of toxicity (p = 0.35). The 5-year actuarial complication rate of 80 patients undergoing long-course ADT was 31.1%; the corresponding rate for the 92 patients who received no ADT or short-course ADT was 22.2%.Conclusion: Adverse effects with long-course ADT on persistent GU morbidity were observed in this study. Additional investigation is needed to identify suitable ADT administration according to risk groups, but long-course ADT should not be adopted for non-high-risk prostate cancer patients to reduce the GU toxicity rate with C-ion RT. (C) 2008 Elsevier Inc.