Department of Radiation Medicine, Georgetown University Hospital.
Technol Cancer Res Treat. 2010 Dec;9(6):583-7. doi: 10.1177/153303461000900606.
We describe the first histopathologic analysis of prostatic tissue following hypofractionated robotic radiation therapy. A 66 year-old man presented with stage II, low risk adenocarcinoma of the prostate and underwent elective conformal hypofractionated radiation therapy. His pretreatment evaluation revealed T1c adenocarcinoma, Gleason's grade 3 + 3 = 6 and a prostate specific antigen (PSA) level of 4.87 ng/ml. Hypofractionated radiation therapy (37.5 Gy in five daily fractions of 7.5 Gy) was completed on an Internal Review Board approved protocol. One year later, he developed progressive urinary retention. Transurethral prostatic resection was performed to alleviate obstructive symptoms. Bilobar hypertrophy was observed without evidence of stricture. Histolopathologic analyses of resected prostate tissues revealed changes consistent with radiation treatment, including cellular changes, inflammation, glandular atrophy and hyperplasia. There was no evidence of residual cancer, fibrosis or necrosis. The patient's postoperative course was uneventful with post-treatment PSA of 0.5 ng/ml and residual grade 1 stress incontinence.
我们描述了首例接受少分割机器人放射治疗后的前列腺组织的组织病理学分析。一位 66 岁的男性患有 II 期低危前列腺腺癌，并接受了选择性适形少分割放射治疗。他的治疗前评估显示 T1c 腺癌、Gleason 分级 3+3=6 和前列腺特异性抗原 (PSA) 水平为 4.87ng/ml。根据内部审查委员会批准的方案，完成了少分割放射治疗（37.5Gy，每日 5 次，每次 7.5Gy）。一年后，他出现进行性尿潴留。经尿道前列腺切除术缓解了梗阻症状。观察到双侧叶肥大，无狭窄证据。前列腺组织切除的组织病理学分析显示与放射治疗一致的变化，包括细胞变化、炎症、腺体萎缩和增生。没有残留癌症、纤维化或坏死的证据。患者术后恢复顺利，治疗后 PSA 为 0.5ng/ml，残留 1 级压力性尿失禁。
