Nguyen Nam P, Davis Rick, Bose Satya R, Dutta Suresh, Vinh-Hung Vincent, Chi Alexander, Godinez Juan, Desai Anand, Woods William, Altdorfer Gabor, D'Andrea Mark, Karlsson Ulf, Vo Richard A, Sroka Thomas
Department of Radiation Oncology, Howard University , Washington, DC , USA.
Department of Radiation Oncology, Michael D. Wachtel Cancer Center , Oskosh, WI , USA.
Front Oncol. 2015 Feb 2;5:18. doi: 10.3389/fonc.2015.00018. eCollection 2015.
Patients with early stage high-risk prostate cancer (prostate specific antigen > 20, Gleason score > 7) are at high risk of recurrence following prostate cancer irradiation. Radiation dose escalation to the prostate may improve biochemical-free survival for these patients. However, high rectal and bladder dose with conventional three-dimensional conformal radiotherapy may lead to excessive gastrointestinal and genitourinary toxicity. Image-guided radiotherapy (IGRT), by virtue of combining the steep dose gradient of intensity-modulated radiotherapy and daily pretreatment imaging, may allow for radiation dose escalation and decreased treatment morbidity. Reduced treatment time is feasible with hypo-fractionated IGRT and it may improve patient quality of life.
早期高危前列腺癌（前列腺特异性抗原>20， Gleason评分>7）患者在接受前列腺癌放疗后复发风险较高。增加前列腺的放射剂量可能会改善这些患者的无生化复发生存率。然而，传统三维适形放疗时直肠和膀胱接受高剂量照射可能会导致过度的胃肠道和泌尿生殖系统毒性。图像引导放疗（IGRT）通过结合调强放疗的陡峭剂量梯度和每日治疗前成像，可能允许增加放射剂量并降低治疗并发症。短程分割IGRT可缩短治疗时间，并且可能改善患者生活质量。
