Department of Radiation Oncology with Division of Medical Radiation Physics, Inselspital, University Hospital, and University of Bern, Bern, Switzerland.
Strahlenther Onkol. 2010 Dec;186(12):687-92. doi: 10.1007/s00066-010-2180-8. Epub 2010 Nov 30.
to report acute and late toxicity in prostate cancer patients treated by high-dose intensity-modulated radiation therapy (IMRT) with daily image-guidance.
from 06/2004-03/2008, 102 men were treated with 80 Gy IMRT with daily image-guidance. The risk groups were as follows: low, intermediate, and high risk in 21%, 27%, and 52% of patients, respectively. Hormone therapy was given to 65% of patients. Toxicity was scored according to the CTC scale version 3.0.
median age was 69 years and median follow-up was 39 months (range, 16-61 months). Acute and late grade 2 gastrointestinal (GI) toxicity occurred in 2% and 5% of patients, respectively, while acute and late grade 3 GI toxicity was absent. Grade 2 and 3 pretreatment genitourinary (GU) morbidity (PGUM) were 15% and 2%, respectively. Acute grade 2 and 3 GU toxicity were 43% and 5% and late grade 2 and 3 GU toxicity were 21% and 1%, respectively. After multiple Cox regression analysis, PGUM was an independent predictor of decreased late ≥ grade 2 GU toxicity-free survival (hazard ratio = 9.4 (95% confidence interval: 4.1, 22.0), p < 0.001). At the end of follow-up, the incidence of late grade 2 and 3 GU toxicity decreased to 7% and 1%, respectively.
GI toxicity rates after IMRT with daily image-guidance were excellent. GU toxicity rates were acceptable and strongly related to PGUM.
报告采用每日图像引导高强度调强放疗（IMRT）治疗前列腺癌患者的急性和晚期毒性。
2004 年 6 月至 2008 年 3 月，102 例患者接受 80Gy IMRT 联合每日图像引导治疗。风险组分别为：低危、中危和高危患者占 21%、27%和 52%。65%的患者接受了激素治疗。毒性根据 CTC 量表 3.0 进行评分。
中位年龄为 69 岁，中位随访时间为 39 个月（16-61 个月）。急性和晚期 2 级胃肠道（GI）毒性分别为 2%和 5%，而无 3 级 GI 毒性。预处理泌尿生殖系统（GU）发病率 2 级和 3 级分别为 15%和 2%。急性 2 级和 3 级 GU 毒性分别为 43%和 5%，晚期 2 级和 3 级 GU 毒性分别为 21%和 1%。经多因素 Cox 回归分析，PGUM 是晚期≥2 级 GU 毒性无复发生存率降低的独立预测因素（危险比=9.4（95%置信区间：4.1，22.0），p<0.001）。随访结束时，晚期 2 级和 3 级 GU 毒性的发生率分别降至 7%和 1%。
每日图像引导 IMRT 后 GI 毒性发生率极佳。GU 毒性发生率可接受，且与 PGUM 密切相关。
