Department of Radiation Oncology, Instituto Madrileño de Oncología/Grupo IMO, Clinica La Milagrosa, Calle Modesto Lafuente, 14, 28010 Madrid, Spain.
Clin Transl Oncol. 2013 Apr;15(4):271-7. doi: 10.1007/s12094-012-0907-y. Epub 2012 Jul 24.
The purpose of this study is to evaluate the tolerability of hypofractionated helical tomotherapy (HT) in the treatment of localized prostate cancer.
We evaluated 48 patients with primary adenocarcinoma of the prostate (cT1-T3N0M0) who were treated with hypofractionated HT from August 2008 through July 2011. Hypofractionated regimens included: 68.04 Gy at 2.52 Gy/fraction, 70 Gy at 2.5 Gy/fraction, and 70.2 Gy at 2.6 Gy/fraction. Genitourinary (GU) and gastrointestinal (GI) toxicity was scored using the Radiation Therapy Oncology Group scoring system.
Thirty-two patients were treated with 68.04 Gy, 5 patients with 70 Gy, and 11 with 70.2 Gy. The median age at diagnosis was 69 years (range 49-87) and the median follow-up 11 months (range 7-40). Grade 2 acute GI toxicity occurred in 9 patients (19 %). No grade 3 or higher acute GI toxicity was observed. Grade 2 and 3 acute GU toxicities occurred in 19 and 6 % of patients, respectively. The incidence of late grade 2 GI and GU toxicity was 4 and 2 %, respectively. No grade 3 or higher late toxicities were observed. Multivariate analysis showed that patients treated at 2.6 Gy/fraction or those who received a total radiation dose ≥70 Gy had higher rates of grade ≥2 acute GU toxicity (P = 0.004 and P = 0.048, respectively).
Hypofractionated HT in the treatment of localized prostate cancer is well tolerated with no grade 3 or higher early or late GI and GU toxicities. Further research is needed to assess definitive late toxicity and tumor control.
本研究旨在评估局部前列腺癌调强适形螺旋断层放疗（HT）的耐受性。
我们评估了 2008 年 8 月至 2011 年 7 月期间采用调强适形螺旋断层放疗治疗的 48 例原发性前列腺腺癌患者。调强适形螺旋断层放疗方案包括：68.04Gy/2.52Gy/次，70Gy/2.5Gy/次和 70.2Gy/2.6Gy/次。采用放射治疗肿瘤协作组评分系统对泌尿生殖系（GU）和胃肠道（GI）毒性进行评分。
32 例患者接受 68.04Gy 治疗，5 例患者接受 70Gy 治疗，11 例患者接受 70.2Gy 治疗。诊断时的中位年龄为 69 岁（范围 49-87 岁），中位随访时间为 11 个月（范围 7-40 个月）。9 例（19%）患者出现 2 级急性 GI 毒性，无 3 级或更高的急性 GI 毒性。19%和 6%的患者分别出现 2 级和 3 级急性 GU 毒性。晚期 2 级和 3 级 GI 和 GU 毒性的发生率分别为 4%和 2%。未观察到 3 级或更高的晚期毒性。多变量分析显示，2.6Gy/次或总放疗剂量≥70Gy 的患者急性 GU 毒性≥2 级的发生率更高（P=0.004 和 P=0.048）。
局部前列腺癌调强适形螺旋断层放疗耐受性良好，无 3 级或更高的早期或晚期 GI 和 GU 毒性。需要进一步研究来评估明确的晚期毒性和肿瘤控制。
