Research on improvement of precision in high-dose-rate brachytherapy for prostate cancer

提高前列腺癌高剂量率近距离放射治疗精度的研究

• 批准号: 17390334
• 负责人: YOSHIOKA Yasuo
• 金额: $ 8.58万
• 依托单位: Osaka University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (B)
• 财政年份: 2005
• 资助国家: 日本
• 起止时间: 2005 至 2006
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-17390334/
• 关键词: prostate cancer; radiotherapy; radiation therapy; brachytherapy; high-dose-rate; interstitial radiotherapy; 組織内照射

From May 1995 through December 2005, 122 patients with prostate cancer were treated with high-dose-rate brachytherapy as monotherapy (i.e. without external beam radiotherapy) at Osaka University Hospital. The median follow-up time was 33 months (range, 6-129). Most of the patients were treated with 54 Gy/9 fractions/5 days, which corresponded to 116 Gy with 2 Gy/fraction on the assumption of a/β =1.5 Gy using LQ model. The 5-year overall survival rate for all patients was 94%, local control rate 97%, and PSA control rate 77%. The 5-year PSA control rates for low-, intermediate-, and high-risk groups were 91%, 92%, and 67%, respectively. Acute Grade 3 toxicity was observed in 6 patients, Grade 2 in 24 patients, and Grade 1 in 59 patients. Late Grade 3 toxicity was observed in 2 patients, Grade 2 in 13 patients, and Grade 1 in 28 patients. High-dose-rate brachytherapy with our regimen was feasible and its toxicity acceptable. The preliminary and interim results were both comparable with other literature. Because it can treat even extracapsular lesion and because it can administer a high dose to the prostate, it was suggested that high-dose-rate brachytherapy as monotherapy was effective to the locally advanced prostate cancer.In the field of treatment planning process, we showed superiority of Anatomy-based dwell positions, where dwell positions were arranged according to the figure of prostate to conventional cylindrical dwell positions; and also superiority of Inverse optimization. Second, we applied our original Attraction-Repulsion Model, and showed a possibility that the new algorithm overcame commercial-based ones.We also invented and reported a new method that enabled the patients to walk around while they were implanted the needles for brachytherapy, with the intention to improve their quality of life during treatment when otherwise they should be on bed for 4 or 5 days.

从1995年5月至2005年12月，122例前列腺癌患者在大坂大学医院接受了高剂量率近距离放射治疗作为单一疗法（即无外照射放疗）。中位随访时间为33个月（范围，6-129）。大多数患者接受54戈伊/9次/5天的治疗，使用LQ模型假设a/β =1.5戈伊，相当于116戈伊，2戈伊/次。所有患者的5年总生存率为94%，局部控制率为97%，PSA控制率为77%。低、中和高风险组的5年PSA控制率分别为91%、92%和67%。在6例患者中观察到3级急性毒性，在24例患者中观察到2级急性毒性，在59例患者中观察到1级急性毒性。在2例患者中观察到晚期3级毒性，在13例患者中观察到2级毒性，在28例患者中观察到1级毒性。高剂量率近距离放射治疗是可行的，其毒性可以接受。初步和中期结果均与其他文献相当。由于高剂量率近距离放射治疗可以治疗囊外病变，并且可以对前列腺进行高剂量治疗，因此，高剂量率近距离放射治疗作为单药治疗对局部晚期前列腺癌是有效的。在治疗计划过程中，我们显示了基于解剖学的驻留位置的优越性，其中驻留位置根据前列腺的形状进行安排，传统的圆柱形驻留位置;以及逆优化的优越性。其次，我们应用了我们最初的吸引-排斥模型，并展示了新算法克服商业算法的可能性。我们还发明并报道了一种新方法，该方法使患者能够在植入近距离放射治疗针时四处走动，旨在改善治疗期间的生活质量，否则他们应该卧床4或5天。

项目成果

Evaluation of anatomy-based dwell position and inverse optimization in high-dose-rate brachytherapy of prostate cancer: a dosimetric comparison to a conventional cylindrical dwell position, geometric optimization, and dose-point optimization

• DOI: 10.1016/j.radonc.2005.02.006
• 发表时间: 2005-06-01
• 期刊: RADIOTHERAPY AND ONCOLOGY
• 影响因子: 5.7
• 作者: Yoshioka, Y;Nishimura, T;Murayama, S
• 通讯作者: Murayama, S

High-dose-rate brachytherapy combined with long-term hormonal therapy for high-risk prostate cancer : results of a retrospective analysis.

高剂量率近距离放射治疗联合长期激素治疗高危前列腺癌：回顾性分析结果。

• 发表时间: 2006
• 期刊: Radiat Med 24
• 作者: Oh RJ;Yoshioka Y;Tanaka E;Shiomi H;Sumida I;Isohashi F;Suzuki 0;Konishi K;Kawaguchi Y;Nakamura S;Kato M;Inoue T
• 通讯作者: Inoue T

Dose optimization using the Attraction-Repulsion Model (ARM) : Basic study for the HDR simple model.

使用吸引-排斥模型 (ARM) 进行剂量优化：HDR 简单模型的基础研究。

• 发表时间: 2005
• 期刊: J Jpn Soc Ther Radiol Oncol 17
• 作者: Shiomi H;Sumida I;Oh RJ;Yoshioka Y;Isohashi F;Suzuki 0;Konishi K;Kawaguchi Y;Inoue T
• 通讯作者: Inoue T

New ambulatory implant technique of high-dose-rate interstitial brachytherapy for prostate cancer

新型高剂量率间质近距离放射治疗前列腺癌门诊植入技术

• 发表时间: 2006
• 期刊: Radiat Med 24
• 作者: Sumida I;Oh RJ;Yoshioka Y;Yoshida K
• 通讯作者: Yoshida K

New ambulatory implant technique of high-dose-rate interstitial brachytherapy for prostate cancer.

前列腺癌高剂量间质近距离放射治疗的新型门诊植入技术。

• 发表时间: 2006
• 期刊: Radiat Med 24
• 作者: Yoshida K;Nose T;Shiomi H;Yoshioka Y;Fujita Y;Kuroda S;Yoshida M;Takahashi T;Kitamura M;Akai H;Oka T;Hosoki T
• 通讯作者: Hosoki T