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前列腺癌治疗中的放射疗法:韩国医疗模式研究结果

Radiotherapy in prostate cancer treatment: results of the patterns of care study in Korea.

作者信息

Chang Ah Ram, Park Won

机构信息

Department of Radiation Oncology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.

Division for Urologic Cancer, Korean Radiation Oncology Group, Seoul, Korea.

出版信息

Radiat Oncol J. 2017 Mar;35(1):25-31. doi: 10.3857/roj.2016.01984. Epub 2017 Mar 17.

Abstract

PURPOSE

The purpose of this study was to describe treatment patterns of radiotherapy (RT) for prostate cancer in Korea.

MATERIALS AND METHODS

A questionnaire about radiation treatment technique and principles in 2013 was sent to 83 radiation oncologists and data from 57 hospitals were collected analyzed to find patterns of RT for prostate cancer patients in Korea.

RESULTS

The number of patients with prostate cancer treated with definitive RT ranged from 1 to 72 per hospital in 2013. RT doses and target volumes increased according to risk groups but the range of radiation doses was wide (60 to 81.4 Gy) and the fraction size was diverse (1.8 to 5 Gy). Intensity-modulated radiation therapy was used for definitive treatment in 93.8% of hospitals. Hormonal therapy was integrated with radiation for intermediate (63.2%) and high risk patients (77.2%). Adjuvant RT after radical prostatectomy was performed in 46 hospitals (80.7%). Indications of adjuvant RT included positive resection margin, seminal vesicle invasion, and capsular invasion. The total dose for adjuvant RT ranged from 50 to 72 Gy in 24-39 fractions. Salvage RT was delivered with findings of consecutive elevations in prostate-specific antigen (PSA), PSA level over 0.2 ng/mL, or clinical recurrence. The total radiation doses ranged from 50 to 80 Gy with a range of 1.8 to 2.5 Gy per fraction for salvage RT.

CONCLUSION

This nationwide patterns of care study suggests that variable radiation techniques and a diverse range of dose fractionation schemes are applied for prostate cancer treatment in Korea. Standard guidelines for RT in prostate cancer need to be developed.

摘要

目的

本研究旨在描述韩国前列腺癌放射治疗(RT)的治疗模式。

材料与方法

2013年向83名放射肿瘤学家发送了一份关于放射治疗技术和原则的调查问卷,并收集分析了57家医院的数据,以找出韩国前列腺癌患者的RT模式。

结果

2013年,每家医院接受根治性RT治疗的前列腺癌患者数量从1例到72例不等。RT剂量和靶体积根据风险组增加,但放射剂量范围较宽(60至81.4 Gy),分次剂量各不相同(1.8至5 Gy)。93.8%的医院使用调强放射治疗进行根治性治疗。对于中危(63.2%)和高危患者(77.2%),激素治疗与放疗联合应用。46家医院(80.7%)在前列腺癌根治术后进行了辅助RT。辅助RT的指征包括手术切缘阳性、精囊侵犯和包膜侵犯。辅助RT的总剂量在24 - 39分次中为50至72 Gy。挽救性RT在前列腺特异性抗原(PSA)持续升高、PSA水平超过0.2 ng/mL或临床复发时进行。挽救性RT的总放射剂量为50至80 Gy,每次分次剂量范围为1.8至2.5 Gy。

结论

这项全国性的治疗模式研究表明,韩国在前列腺癌治疗中应用了多种放射技术和不同的剂量分割方案。需要制定前列腺癌RT的标准指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91a3/5398354/e86df8c65f1a/roj-2016-01984f1.jpg

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