Hypofractionated intensity-modulated radiotherapy (70 GY at 2.5 GY per fraction) for localized prostate cancer: Long-term outcomes
Hypofractionated intensity-modulated radiotherapy (70 GY at 2.5 GY per fraction) for localized prostate cancer: Long-term outcomes
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DOI：
10.1016/j.ijrobp.2005.05.054
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发表时间：
2005-12-01
影响因子：
7
通讯作者：
Mahadevan, A
中科院分区：
文献类型：
--
作者：
Kupelian, PA;Thakkar, VV;Mahadevan, A
目的：为了分析长期无复发生存率和毒性率在患者接受高分割调强radiotherapy.Methods和Materials：研究样本包括第一个100连续局部前列腺癌患者治疗70.0戈伊在2.5戈伊每部分。中位随访时间为66个月（范围：3 - 75个月）。生化失败是研究终点，使用ASTRO定义（A-bRFS）和替代“最低值+2 ng/mL”定义（N-bRFS）。结果：所有病例的5年A-bRFS和N-bRFS率分别为85%（95%CI，78 - 93%）和88%（95%CI，82- 95%）。对于低、中和高风险疾病，5年A-bRFS率分别为97%、88%和70%。相应的5年N-bRFS率分别为97%、93%和75%。20例患者的急性直肠毒性评分为0分，61例患者为1分，19例患者为2分。急性泌尿毒性评分为0分9例，1分76例，2分15例。晚期直肠毒性评分分别为0分71例，1分19例，2分7例，3分3例。5年时，晚期3级直肠毒性的精算发生率为3%。观察到的一些毒性自发消退或得到纠正。末次随访时，5年时2级和3级晚期直肠毒性的发生率仅为5%。75例患者的晚期泌尿毒性评分为0，13例患者为1，11例患者为2，1例患者为3。结论：大剂量小剂量分次放疗后的远期疗效良好，中位随访时间为66个月。晚期毒性（泌尿和直肠）有限。高剂量低分割是治疗局限性前列腺癌的替代剂量递增方法。(c)2005年爱思唯尔公司
Purpose: To analyze the long-term relapse-free survival and toxicity rates in patients treated with hypofractionated intensity-modulated radiotherapy.Methods and Materials: The study sample includes the first 100 consecutive localized prostate cancer patients treated to 70.0 Gy at 2.5 Gy per fraction. The median follow-up was 66 months (range, 3 to 75 months). Biochemical failure was the study endpoint, using both the ASTRO definition (A-bRFS) and the alternate "nadir + 2 ng/mL" definition (N-bRFS). RTOG scores were used to assess toxicity.Results: The 5-year A-bRFS and N-bRFS rates were 85 % (95 % CI, 78 -93 %) and 88 % (95 % CI, 82-95 %) for all cases, respectively. For low, intermediate and high-risk disease, the 5-year A-bRFS rates were 97%, 88%, and 70%. The corresponding 5-year N-bRFS rates were 97%, 93%, and 75%, respectively. The acute rectal toxicity scores were 0 in 20, 1 in 61, and 2 in 19 patients. The acute urinary toxicity scores were 0 in 9, 1 in 76, and 2 in 15 patients. The late rectal toxicity scores were 0 in 71, 1 in 19, 2 in 7, and 3 in 3 patients. The actuarial late Grade 3 rectal toxicity rate at 5 years was 3%. A number of the toxicities observed either resolved spontaneously or were corrected. At last follow-up, the rate of combined Grades 2 and 3 late rectal toxicity at 5 years was only 5%. The late urinary toxicity scores were 0 in 75, 1 in 13, 2 in 11, and 3 in 1 patients. The actuarial late Grade 3 urinary toxicity rate at 5 years was 1%.Conclusion: With a median follow-up of 66 months, the long-term results after high-dose hypofractionation are excellent. Late toxicity, urinary and rectal, has been limited. High-dose hypofractionation is an alternative dose escalation method in the treatment of localized prostate cancer. (c) 2005 Elsevier Inc.