Winthrop University Hospital, Mineola, NY, USA.
Technol Cancer Res Treat. 2010 Dec;9(6):575-82. doi: 10.1177/153303461000900605.
Stereotactic body radiotherapy (SBRT) boost following external beam radiation therapy (EBRT) for advanced localized prostate cancer may reduce toxicity while escalating the dose. We present preliminary biochemical control and urinary, rectal and sexual toxicities for 73 patients treated with SBRT as a boost to EBRT. Forty-one intermediate- and 32 high-risk localized prostate cancer patients received 45 Gy EBRT with SBRT boost. Twenty-eight patients (38.3%) received a total SBRT boost dose of 18 Gy (3 fractions of 6 Gy), 28 patients (38.3%) received 19.5 Gy (3 fractions of 6.5 Gy), and 17 patients (23.2%) received 21 Gy (3 fractions of 7 Gy). Toxicity was assessed using the Radiation Therapy Oncology Group urinary and rectal toxicity scale. Biochemical failure was assessed using the Phoenix definition. The median follow-up was 33 months (range, 22 - 43 months). Less than 7% Grade II and no higher grade acute toxicities occurred. To date, one Grade III and no Grade IV late toxicities occurred. For the 97% of patients with 24 months minimum follow-up, 71.8% achieved a PSA nadir threshold of 0.5 ng/mL. Three intermediate-risk and seven high-risk biochemical failures occurred; one high-risk patient died of his cancer. Three-year actuarial biochemical control rates were 89.5% and 77.7% for intermediate- and high-risk patients, respectively. SBRT boost for prostate cancer treatment is safe and feasible with minimal acute toxicity. At 33 months late toxicity and biochemical control are promising. Long-term durability of these findings remains to be established.
立体定向体部放射治疗（SBRT）在外部束放射治疗（EBRT）后对晚期局限性前列腺癌进行增敏可能会降低毒性，同时提高剂量。我们对 73 例接受 SBRT 增敏 EBRT 治疗的患者的初步生化控制和尿、直肠和性功能毒性进行了介绍。41 例中危和 32 例高危局限性前列腺癌患者接受 45 Gy EBRT 联合 SBRT 增敏。28 例（38.3%）患者接受了总 SBRT 增敏剂量 18 Gy（3 次 6 Gy），28 例（38.3%）患者接受了 19.5 Gy（3 次 6.5 Gy），17 例（23.2%）患者接受了 21 Gy（3 次 7 Gy）。使用放射治疗肿瘤学组的尿和直肠毒性量表评估毒性。使用 Phoenix 定义评估生化失败。中位随访时间为 33 个月（范围 22-43 个月）。急性毒性低于 7%的 II 级，没有更高的 III 级毒性。迄今为止，有 1 例 III 级和无 IV 级晚期毒性。在 97%有 24 个月最低随访时间的患者中，71.8%达到了 PSA 最低阈值 0.5 ng/mL。3 例中危和 7 例高危生化失败，1 例高危患者死于癌症。3 年生化无进展生存率分别为中危和高危患者的 89.5%和 77.7%。SBRT 增敏治疗前列腺癌是安全可行的，急性毒性最小。33 个月的晚期毒性和生化控制结果有希望。这些发现的长期耐久性仍有待确定。
