Hypofractionated intensity-modulated radiotherapy (70 Gy at 2.5 Gy per fraction) for localized prostate cancer: Cleveland Clinic experience
Hypofractionated intensity-modulated radiotherapy (70 Gy at 2.5 Gy per fraction) for localized prostate cancer: Cleveland Clinic experience
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DOI：
10.1016/j.ijrobp.2007.01.067
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发表时间：
2007-08-01
影响因子：
7
通讯作者：
Mahadevan, Arul
中科院分区：
文献类型：
--
作者：
Kupelian, Patrick A.;Willoughby, Twyla R.;Mahadevan, Arul
目的：研究局限型前列腺癌患者在5周内接受剂量为70Gy2.5次/次的治疗效果。方法和材料：研究样本包括1998年至2005年在克利夫兰诊所接受低分割调强放射治疗的770例局限型前列腺癌患者。中位随访期为45个月(最长86个月)。结果：ASTRO 5年生化无复发生存率为82%(95%可信区间，79~85%)，5年低谷+2 ng/mL生存率为83%(95%可信区间，79~86%)。对于低风险、中风险和高风险疾病的患者，5年ASTRO率分别为95%、85%和68%。低危、中危和高危患者的5年低危率分别为94%、83%和72%。放射治疗肿瘤组51%的患者急性直肠毒性评分为0，40%的患者为1，9%的患者为2。急性尿毒性评分为0分者占33%，1分者占48%，2分者占18%，3分者占1%。晚期直肠毒性评分0分占89.6%，1分占5.9%，2分占3.1%，3分占1.3%，4分占0.1%(1例)。晚期尿毒反应评分为0分者占90.5%，1分者占4.3%，2分者占5.1%，3分者占0.1%(1例)。(C)2007年爱思唯尔公司。
Purpose: To study the outcomes in patients treated for localized prostate cancer with 70 Gy delivered at 2.5-Gy/fraction within 5 weeks.Methods and Materials: The study sample included all 770 consecutive patients with localized prostate cancer treated with hypofractionated intensity-modulated radiotherapy at the Cleveland Clinic between 1998 and 2005. The median follow-up was 45 months (maximum, 86). Both the American Society for Therapeutic Radiology and Oncology (ASTRO) biochemical failure definition and the alternate nadir + 2 ng/mL definition were used.Results: The overall 5-year ASTRO biochemical relapse-free survival rate was 82% (95% confidence interval, 79-85%), and the 5-year nadir + 2 ng/mL rate was 83% (95% confidence interval, 79-86%). For patients with low-risk, intermediate-risk, and high-risk disease, the 5-year ASTRO rate was 95%, 85%, and 68%, respectively. The 5-year nadir + 2 ng/mL rate for patients with low-, intermediate-, and high-risk disease was 94%, 83%, and 72%, respectively. The Radiation Therapy Oncology Group acute rectal toxicity scores were 0 in 51%, 1 in 40%, and 2 in 9% of patients. The acute urinary toxicity scores were 0 in 33%, 1 in 48%, 2 in 18%, and 3 in 1% of patients. The late rectal toxicity scores were 0 in 89.6%, 1 in 5.9%, 2 in 3.1%,3 in 1.3%, and 4 in 0.1% (1 patient). The late urinary toxicity scores were 0 in 90.5 %, 1 in 4.3%, 2 in 5.1 %, and 3 in 0.1 % (1 patient).Conclusion: The outcomes after high-dose hypofractionation were acceptable in the entire cohort of patients treated with the schedule of 70 at 2.5 Gy/fraction. (C) 2007 Elsevier Inc.