Department of Radiation Oncology, Centre Georges Francois Leclerc, Dijon, France.
Radiother Oncol. 2012 May;103(2):244-6. doi: 10.1016/j.radonc.2011.10.025. Epub 2011 Nov 25.
To evaluate the impact of PTV reduction when delivering image-guided IMRT (IG-IMRT) for patients with prostate cancer. Between 2001 and 2007, 165 men were treated with daily IG-IMRT using a 3D ultrasound-based system. Median dose prescribed to the prostate was 78 Gy [74 Gy-78 Gy]. Patients were stratified regarding the CTV to the PTV margin: group A (n=87)=5mm or group B (n=78)=10mm. Late toxicity was scored using the CTC v3.0 scale. Biochemical progression-free survival (bPFS) was calculated using the Phoenix definition. Grade 2 genitourinary toxicity was 7.0% for group A and 6.6% for group B (p=1.00). Grade 2 gastrointestinal toxicity was 1.2% and 2.6% (p=0.38). With a median follow-up of 38.3 months [5.25-87.3], bPFS at 3 years was 92.5% [82.4%-96.9%] in group A and 94.3% [85.5%-97.8%] in group B (p=0.84). IG-IMRT yielded very low rates of late toxicity. Margin had impact neither on short-term bPFS nor late toxicity.
评估在为前列腺癌患者提供图像引导调强放疗（IG-IMRT）时减少计划靶区（PTV）的影响。2001 年至 2007 年间，165 名男性接受了基于三维超声的系统进行的每日 IG-IMRT 治疗。规定前列腺的中位剂量为 78 Gy[74 Gy-78 Gy]。根据 CTV 到 PTV 边界，患者分层为：A 组（n=87）=5mm 或 B 组（n=78）=10mm。使用 CTC v3.0 量表对晚期毒性进行评分。使用 Phoenix 定义计算生化无进展生存率（bPFS）。A 组的 2 级泌尿生殖系统毒性为 7.0%，B 组为 6.6%（p=1.00）。A 组和 B 组的 2 级胃肠道毒性分别为 1.2%和 2.6%（p=0.38）。在中位随访 38.3 个月[5.25-87.3]后，A 组的 3 年 bPFS 为 92.5%[82.4%-96.9%]，B 组为 94.3%[85.5%-97.8%]（p=0.84）。IG-IMRT 导致晚期毒性的发生率非常低。边界对短期 bPFS 或晚期毒性均无影响。
