Department of Radiation Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusaku, Nagoya 464-8681, Japan.
J Cancer Res Clin Oncol. 2012 Nov;138(11):1931-6. doi: 10.1007/s00432-012-1277-0. Epub 2012 Jul 1.
We present the preliminary results of intensity-modulated radiation therapy with helical tomotherapy (HT) for clinically localized prostate cancer.
Regularly followed 241 consecutive patients, who were treated with HT between June 2006 and December 2010, were included in this retrospective study. Most patients received both relatively long-term neoadjuvant and adjuvant androgen deprivation therapy (ADT). Patients received 78 Gy in the intermediate high-risk group and 74 Gy in the low-risk group. Biochemical disease-free survival (bDFS) followed the Phoenix definition. Toxicity was scored according to the Radiation Therapy Oncology Group morbidity grading scale.
The median follow-up time from the start date of HT was 35 months. The rates of acute Grade 2 gastro-intestinal (GI) and genitor-urinary (GU) toxicities were 11.2 and 24.5 %. No patients experienced acute Grade 3 or higher symptoms. The rates of late Grade 2 and 3 GI toxicities were 6.6 and 0.8 %, and those of late Grade 2 and 3 GU toxicities were 8.3 % and 1.2 %. No patients experienced late Grade 4 toxicity. The 3-year bDFS rates for low, intermediate, and high-risk group patients were 100, 100, and 95.8 %, respectively. We observed clinical relapse in two high-risk patients, resulting in a 3-year clinical DFS of 99.4 %.
This preliminary report confirms the feasibility of HT in a large number of patients. We observed that HT is associated with low rates of acute and late toxicities, and HT in combination with relatively long-term ADT results in excellent short-term bDFS.
我们展示了螺旋断层放疗（HT）治疗局限性前列腺癌的初步结果。
回顾性分析了 2006 年 6 月至 2010 年 12 月期间接受 HT 治疗的 241 例连续患者。大多数患者接受了相对较长时间的新辅助和辅助雄激素剥夺治疗（ADT）。中高危组患者接受 78Gy，低危组患者接受 74Gy。生化无病生存期（bDFS）采用凤凰定义。毒性根据放射治疗肿瘤学组发病率分级标准进行评分。
从 HT 开始日期到随访中位数时间为 35 个月。急性 2 级胃肠道（GI）和生殖泌尿系统（GU）毒性发生率分别为 11.2%和 24.5%。没有患者发生急性 3 级或更高级别的症状。晚期 2 级和 3 级 GI 毒性发生率分别为 6.6%和 0.8%，晚期 2 级和 3 级 GU 毒性发生率分别为 8.3%和 1.2%。没有患者发生晚期 4 级毒性。低危、中危和高危组患者的 3 年 bDFS 率分别为 100%、100%和 95.8%。我们观察到两名高危患者出现临床复发，导致 3 年临床 DFS 率为 99.4%。
本初步报告证实了 HT 在大量患者中的可行性。我们观察到 HT 与低急性和晚期毒性相关，并且 HT 联合相对较长时间的 ADT 可获得良好的短期 bDFS。
