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螺旋断层放疗图像引导下的大分割放疗治疗前列腺癌：毒性及对最低点前列腺特异抗原的影响

Image guided hypofractionated radiotherapy by helical tomotherapy for prostate carcinoma: toxicity and impact on Nadir PSA.

作者信息

Barra Salvina, Vagge Stefano, Marcenaro Michela, Blandino Gladys, Timon Giorgia, Vidano Giulia, Agnese Dario, Gusinu Marco, Cavagnetto Francesca, Corvò Renzo

机构信息

Department of Radiation Oncology, IRCCS San Martino-IST, National Cancer Research Institute, 16100 Genoa, Italy.

University of Genoa, DISSAL, 16100 Genoa, Italy.

出版信息

Biomed Res Int. 2014;2014:541847. doi: 10.1155/2014/541847. Epub 2014 Mar 18.

DOI:10.1155/2014/541847
PMID:24745018
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3976914/
Abstract

AIM

To evaluate the toxicity of a hypofractionated schedule for primary radiotherapy (RT) of prostate cancer as well as the value of the nadir PSA (nPSA) and time to nadir PSA (tnPSA) as surrogate efficacy of treatment.

MATERIAL AND METHODS

Eighty patients underwent hypofractionated schedule by Helical Tomotherapy (HT). A dose of 70.2 Gy was administered in 27 daily fractions of 2.6 Gy. Acute and late toxicities were graded on the RTOG/EORTC scales. The nPSA and the tnPSA for patients treated with exclusive RT were compared to an equal cohort of 20 patients treated with conventional fractionation and standard conformal radiotherapy.

RESULTS

Most of patients (83%) did not develop acute gastrointestinal (GI) toxicity and 50% did not present genitourinary (GU) toxicity. After a median follow-up of 36 months only grade 1 of GU and GI was reported in 6 and 3 patients as late toxicity. Average tnPSA was 30 months. The median value of nPSA after exclusive RT with HT was 0.28 ng/mL and was significantly lower than the median nPSA (0.67 ng/mL) of the conventionally treated cohort (P = 0.02).

CONCLUSIONS

Hypofractionated RT schedule with HT for prostate cancer treatment reports very low toxicity and reaches a low level of nPSA that might correlate with good outcomes.

摘要

目的

评估前列腺癌一次大剂量分割放疗方案的毒性，以及最低前列腺特异性抗原（nPSA）和达到最低前列腺特异性抗原的时间（tnPSA）作为治疗替代疗效指标的价值。

材料与方法

80例患者接受螺旋断层放疗（HT）的大剂量分割方案。给予27次每日剂量为2.6 Gy的照射，总剂量70.2 Gy。急性和晚期毒性反应按照美国放射肿瘤学会/欧洲癌症研究与治疗组织（RTOG/EORTC）标准分级。将单纯接受放疗患者的nPSA和tnPSA与20例接受常规分割及标准适形放疗的同等队列患者进行比较。

结果

大多数患者（83%）未发生急性胃肠道（GI）毒性反应，50%未出现泌尿生殖系统（GU）毒性反应。中位随访36个月后，仅6例和3例患者分别出现1级GU和GI晚期毒性反应。平均tnPSA为30个月。HT单纯放疗后nPSA的中位值为0.28 ng/mL，显著低于传统治疗队列的nPSA中位值（0.67 ng/mL）（P = 0.02）。

结论

采用HT进行大剂量分割放疗方案治疗前列腺癌的毒性反应很低，且nPSA水平较低，这可能与良好的治疗效果相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86d1/3976914/2e0e859550f1/BMRI2014-541847.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86d1/3976914/a03f0f53f78c/BMRI2014-541847.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86d1/3976914/5f9d2aabf8ce/BMRI2014-541847.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86d1/3976914/b47a439aea90/BMRI2014-541847.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86d1/3976914/a2ec0d0b8d01/BMRI2014-541847.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86d1/3976914/83bea8cf047a/BMRI2014-541847.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86d1/3976914/2e0e859550f1/BMRI2014-541847.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86d1/3976914/a03f0f53f78c/BMRI2014-541847.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86d1/3976914/5f9d2aabf8ce/BMRI2014-541847.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86d1/3976914/b47a439aea90/BMRI2014-541847.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86d1/3976914/a2ec0d0b8d01/BMRI2014-541847.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86d1/3976914/83bea8cf047a/BMRI2014-541847.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86d1/3976914/2e0e859550f1/BMRI2014-541847.006.jpg

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Randomized trial of hypofractionated external-beam radiotherapy for prostate cancer.随机分组试验：前列腺癌的外照射低分割放疗。
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