Tkachev S I, Matveev V B, Trofimova O P, Nazarenko A V, Pylova I V, Priamikova Iu I
Vopr Onkol. 2010;56(2):215-9.
Data are presented on a retrospective comparison of the results of remote radiotherapy and combined treatment of prostate cancer (T2T4NxM0) (88) at the Center's Clinics (1999-2003). Diagnosis was confirmed by morphological evidence: T2NxM0 (group 1)--18.2%, T3aNx M0 (group 2)--53.4%, T3bNx M0 (group 3)--18.2%, T4NxM0--10.2% (group 4). In group 1 (n=37), contemporary radiotherapy was administered--TTD--up to 44 Gy (stage I) and up to 66-70 Gy (stage II). In group 2 (n=51), contemporary radiotherapy was supplemented with inhalation of radioprotector GGS-9--TTD--up to 44 Gy plus GGS-9 (stage I) and up to 72-76 Gy plus conformaton radiotherapy (3D CRT) (stage II). When GGS-9 was used at stage I the rate of acute radiation injury dropped from 56.7% in group 1 to 11.7% in group 2, (p=0.0001). The frequency of late-onset injury was also lower in patients receiving 3D CRT (13.5 and 3.9%, respectively) (p=0.01). Local and biological relapse occurred frequently after contemporary radiotherapy (27%) as compared with conformation one (5.8%). The latter treatment was followed by higher 5-year recurrence-free survival (94.2%) as compared with contemporary radiotherapy (73%), (p=0.0001). Owing to use of 3D CRT, dose distribution was improved as volume and dosage for organs at risk of irradiation decreased, while TTD increased up to 72-76 Gy unaccompanied by a rise in early-onset injuries. On the contrary, late-onset radiation damage fell down.
本文呈现了中心诊所（1999 - 2003年）对前列腺癌（T2T4NxM0）（88例）进行远距离放疗和综合治疗结果的回顾性比较数据。诊断依据形态学证据确定：T2NxM0（第1组）——18.2%，T3aNxM0（第2组）——53.4%，T3bNxM0（第3组）——18.2%，T4NxM0——10.2%（第4组）。在第1组（n = 37）中，采用了当代放疗——总治疗剂量（TTD），I期达44 Gy，II期达66 - 70 Gy。在第2组（n = 51）中，当代放疗辅以放射防护剂GGS - 9吸入——TTD，I期达44 Gy加GGS - 9，II期达72 - 76 Gy加适形放疗（3D CRT）。I期使用GGS - 9时，急性放射损伤发生率从第1组的56.7%降至第2组的11.7%，（p = 0.0001）。接受3D CRT的患者迟发性损伤频率也较低（分别为13.5%和3.9%）（p = 0.01）。与适形放疗（5.8%）相比，当代放疗后局部和生物学复发频繁发生（27%）。与当代放疗（73%）相比，后一种治疗的5年无复发生存率更高（94.2%），（p = 0.0001）。由于使用了3D CRT，剂量分布得到改善，因为受照射危险器官的体积和剂量降低，而TTD增加至72 - 76 Gy，且未伴随早期损伤增加。相反，迟发性放射损伤减少。
