Kupelian Patrick A, Willoughby Twyla R, Reddy Chandana A, Klein Eric A, Mahadevan Arul
Department of Radiation Oncology, M.D. Anderson Cancer Center Orlando, Orlando, FL 32806, USA.
Int J Radiat Oncol Biol Phys. 2007 Aug 1;68(5):1424-30. doi: 10.1016/j.ijrobp.2007.01.067. Epub 2007 Jun 4.
To study the outcomes in patients treated for localized prostate cancer with 70 Gy delivered at 2.5-Gy/fraction within 5 weeks.
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.
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).
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.
研究采用5周内以2.5Gy/分次给予70Gy剂量治疗局限性前列腺癌患者的疗效。
研究样本包括1998年至2005年间在克利夫兰诊所接受大分割调强放疗的770例连续的局限性前列腺癌患者。中位随访时间为45个月（最长86个月）。采用了美国放射肿瘤学会（ASTRO）的生化失败定义以及替代的最低点+2ng/mL定义。
总体5年ASTRO生化无复发生存率为82%（95%置信区间，79 - 85%），5年最低点+2ng/mL率为83%（95%置信区间，79 - 86%）。对于低危、中危和高危疾病患者，5年ASTRO率分别为95%、85%和68%。低、中、高危疾病患者的5年最低点+2ng/mL率分别为94%、83%和72%。放射肿瘤学组的急性直肠毒性评分在51%的患者中为0，40%的患者中为1，9%的患者中为2。急性泌尿毒性评分在33%的患者中为0，48%的患者中为1，18%的患者中为2，1%的患者中为3。晚期直肠毒性评分在89.6%的患者中为0，5.9%的患者中为1，3.1%的患者中为2，1.3%的患者中为3，0.1%（1例患者）的患者中为4。晚期泌尿毒性评分在90.5%的患者中为0，4.3%的患者中为1，5.1%的患者中为2，0.1%（1例患者）的患者中为3。
在以2.5Gy/分次给予70Gy剂量方案治疗的整个患者队列中，大分割高剂量放疗后的疗效是可接受的。
