Gawkowska-Suwinska Marzena, Fijałkowski Marek, Białas Brygida, Szlag Marta, Kellas-Ślęczka Sylwia, Nowicka Elżbieta, Behrendt Katarzyna, Plewicki Grzegorz, Smolska-Ciszewska Beata, Giglok Monika, Zajusz Aleksander, Owczarek Grzegorz
2 Department of Radiotherapy.
Department of Brachytherapy.
J Contemp Brachytherapy. 2009 Dec;1(4):211-215. Epub 2010 Jan 13.
The aim of the study was to analyze early effects and toxicity of salvage high dose rate brachytherapy for local recurrences of adenocarcinoma of the prostate after external beam radiotherapy (EBRT).
In MCS Memorial Institute of Oncology in Gliwice a research programme on salvage HDR brachytherapy for local recurrences of prostate cancer treated previously with EBRT has been ongoing since February 2008. The treatment consisted of 3 fractions of 10 Gy each given every 14 days. Maximal urethral doses were constrained to be ≤ 120% of the prescribed dose. Maximal bladder and rectum doses were constrained to be ≤ 70% of the prescribed dose.
Fifteen eligible patients were treated and analyzed from February 2008. All patients completed the treatment without major complications. The most common early complications were: macroscopic haematuria, pain in lower part of the abdomen, and transient dysuria. During the first week after the procedure a transient increase in IPSS score was noticed. The Foley catheter was removed on day 2 to 5. No complications after spinal anaesthesia were observed. Acute toxicity according to EORTC/RTOG was low. For bladder EORTC/RTOG score ranged from 0 to 2. Only in two patients grade 1 toxicity for rectum was observed. The follow-up ranged from 3 to 9 months. In one patient grade 2 rectal toxicity was observed, and one had urethral stricture. Other patients did not have any other significant late toxicity of the treatment. Two patients developed bone metastases.
Salvage brachytherapy for localized prostate cancer (3 × 10 Gy every 14 days) seems to be a safe and well tolerated procedure. A significant decline in prostate-specific antigen (PSA) level is seen in patients with hormone-responsive cancer. Long-term efficiency and toxicity of the procedure are yet to be established.
本研究旨在分析挽救性高剂量率近距离放射治疗对外照射放疗（EBRT）后前列腺癌局部复发的早期疗效和毒性。
自2008年2月起，在格利维采的MCS肿瘤纪念研究所开展了一项关于对先前接受过EBRT治疗的前列腺癌局部复发进行挽救性高剂量率近距离放射治疗的研究项目。治疗方案为每14天给予3次，每次10 Gy。最大尿道剂量限制在规定剂量的≤120%。最大膀胱和直肠剂量限制在规定剂量的≤70%。
2008年2月至2015年2月期间，15例符合条件的患者接受了治疗并进行了分析。所有患者均完成治疗，无严重并发症。最常见的早期并发症为：肉眼血尿、下腹部疼痛和短暂性排尿困难。术后第一周国际前列腺症状评分（IPSS）出现短暂升高。术后第2至5天拔除导尿管。未观察到脊髓麻醉后的并发症。根据欧洲癌症研究与治疗组织（EORTC）/美国放射肿瘤学会（RTOG）标准，急性毒性较低。膀胱EORTC/RTOG评分范围为0至2。仅2例患者观察到直肠1级毒性。随访时间为3至9个月。1例患者观察到2级直肠毒性，1例出现尿道狭窄。其他患者未出现该治疗的任何其他严重晚期毒性。2例患者发生骨转移。
挽救性近距离放射治疗局部前列腺癌（每14天3×10 Gy）似乎是一种安全且耐受性良好的治疗方法。激素反应性癌症患者的前列腺特异性抗原（PSA）水平显著下降。该治疗方法的长期疗效和毒性尚待确定。
