Department of Radiation Oncology, Hospital Israelita Albert Einstein, Av, Albert Einstein, 627/701 - Sao Paulo, Brazil.
Radiat Oncol. 2007 Jan 15;2:6. doi: 10.1186/1748-717X-2-6.
To report the toxicity after intensity modulated radiotherapy (IMRT) for patients with localized prostate cancer, as a sole treatment or after radical prostatectomy.
Between August 2001 and December 2003, 132 patients with prostate cancer were treated with IMRT and 125 were evaluable to acute and late toxicity analysis, after a minimum follow-up time of one year. Clinical and treatment data, including normal tissue dose-volume histogram (DVH) constraints, were reviewed. Gastro-intestinal (GI) and genito-urinary (GU) signs and symptoms were evaluated according to the Radiation Therapy Oncology Group (RTOG) toxicity scales. Median prescribed dose was 76 Gy. Median follow-up time was of 26.1 months.
From the 125 patients, 73 (58.4%) presented acute Grade 1 or Grade 2 GI and 97 (77.2%) presented acute Grade 1 or Grade 2 GU toxicity. Grade 3 GI acute toxicity occurred in only 2 patients (1.6%) and Grade 3 GU acute toxicity in only 3 patients (2.4%). Regarding Grade 1 and 2 late toxicity, 26 patients (20.8%) and 21 patients (16.8%) presented GI and GU toxicity, respectively. Grade 2 GI late toxicity occurred in 6 patients (4.8%) and Grade 2 GU late toxicity in 4 patients (3.2%). None patient presented any Grade 3 or higher late toxicity. Non-conformity to DVH constraints occurred in only 11.2% of treatment plans. On univariate analysis, no significant risk factor was identified for Grade 2 GI late toxicity, but mean dose delivered to the PTV was associated to higher Grade 2 GU late toxicity (p = 0.042).
IMRT is a well tolerable technique for routine treatment of localized prostate cancer, with short and medium-term acceptable toxicity profiles. According to the data presented here, rigid compliance to DHV constraints might prevent higher incidences of normal tissue complication.
报告局限性前列腺癌患者接受调强放疗（IMRT）作为单一治疗或根治性前列腺切除术后的毒性。
2001 年 8 月至 2003 年 12 月，132 例前列腺癌患者接受了调强放疗，125 例可评估急性和晚期毒性分析，随访时间至少为 1 年。回顾了临床和治疗数据，包括正常组织剂量-体积直方图（DVH）限制。根据放射治疗肿瘤学组（RTOG）毒性量表评估胃肠道（GI）和泌尿生殖系统（GU）症状。中位规定剂量为 76Gy。中位随访时间为 26.1 个月。
在 125 例患者中，73 例（58.4%）出现急性 1 级或 2 级 GI 毒性，97 例（77.2%）出现急性 1 级或 2 级 GU 毒性。仅有 2 例（1.6%）发生 3 级 GI 急性毒性，3 例（2.4%）发生 3 级 GU 急性毒性。关于 1 级和 2 级晚期毒性，分别有 26 例（20.8%）和 21 例（16.8%）出现 GI 和 GU 毒性。6 例（4.8%）发生 2 级 GI 晚期毒性，4 例（3.2%）发生 2 级 GU 晚期毒性。无一例患者出现任何 3 级或更高的晚期毒性。只有 11.2%的治疗计划不符合 DVH 限制。单因素分析显示，2 级 GI 晚期毒性无显著危险因素，但 PTV 接受的平均剂量与较高的 2 级 GU 晚期毒性相关（p=0.042）。
IMRT 是治疗局限性前列腺癌的一种可耐受的常规技术，具有短期和中期可接受的毒性特征。根据这里提供的数据，严格遵守 DHV 限制可能会降低正常组织并发症的发生率。
