O'Sullivan J M, Gribbin A, Taylor J, O'Neill L, Cosgrove S, Armstrong J G
St Luke's Hospital, Dublin, Republic of Ireland.
Clin Oncol (R Coll Radiol). 2000;12(4):217-21. doi: 10.1053/clon.2000.9157.
We performed this analysis to document the rate and severity of complications both during and after local field irradiation for localized prostate cancer and to assess the influence of three-dimensional conformal radiation therapy (3DCRT) on these complications. Bowel, urinary and cutaneous toxicities were noted in all patients treated with primary radiotherapy (RT) for prostate cancer using Radiation Therapy Oncology Group/European Organization for Research on Treatment of Cancer scores. Evaluations were performed weekly during RT, 6 weeks after RT and 3 monthly thereafter. Data on 111 were analysed. We also compared the complications of conventional and 3DCRT. The serious complication rates identified in this study compare favourably with those reported in the literature. Only 3.6%, 0.8% and 0% had acute grade 3 or 4 urinary, bowel or skin reactions respectively. Only two patients had chronic grade 3 or 4 urinary complications. Thus far no patients have developed chronic bowel or skin complications greater than grade 2. Despite dose escalation from 66 Gy to 70 Gy (with 3DCRT), there was a trend towards reduced toxicity when 3DCRT was compared with conventional radiation. RT is a well-tolerated treatment for early stage carcinoma of the prostate and our complication rates are compatible with international experiences. Further follow-up is required to determine the efficacy of treatment, the incidence of impotence and the final number of late complications.
我们进行此项分析,以记录局限性前列腺癌局部野照射期间及之后并发症的发生率和严重程度,并评估三维适形放射治疗(3DCRT)对这些并发症的影响。使用放射治疗肿瘤学组/欧洲癌症研究与治疗组织的评分标准,对所有接受前列腺癌原发放疗(RT)的患者记录肠道、泌尿和皮肤毒性反应。放疗期间每周进行评估,放疗后6周及之后每3个月进行评估。对111例患者的数据进行了分析。我们还比较了传统放疗和3DCRT的并发症情况。本研究中确定的严重并发症发生率与文献报道的情况相比更有利。分别仅有3.6%、0.8%和0%的患者出现急性3级或4级泌尿、肠道或皮肤反应。仅有2例患者出现慢性3级或4级泌尿并发症。迄今为止,尚无患者出现大于2级的慢性肠道或皮肤并发症。尽管3DCRT使剂量从66 Gy增加至70 Gy,但与传统放疗相比,3DCRT仍有降低毒性的趋势。放疗是早期前列腺癌耐受性良好的治疗方法,我们的并发症发生率与国际经验相符。需要进一步随访以确定治疗效果、阳痿发生率以及晚期并发症的最终数量。