Pinkawa Michael, Berneking Vanessa, Schlenter Marsha, Krenkel Barbara, Eble Michael J
Department of Radiation Oncology, RWTH Aachen University, Aachen, Germany; Department of Radiation Oncology, MediClin Robert Janker Klinik, Bonn, Germany.
Department of Radiation Oncology, RWTH Aachen University, Aachen, Germany.
Int J Radiat Oncol Biol Phys. 2017 Oct 1;99(2):374-377. doi: 10.1016/j.ijrobp.2017.05.035. Epub 2017 May 31.
To evaluate quality of life changes up to 5 years after prostate cancer radiation therapy (RT) with a hydrogel spacer.
In the years 2010 to 2011, 114 patients received external beam radiation therapy to the prostate; 54 patients were selected for a hydrogel injection before the beginning of RT. Treatment was performed applying fractions of 2 Gy up to a total dose of 76 Gy (n=96) or 78 Gy (n=18, all with hydrogel). Patients were surveyed before RT; at the last day of RT; and a median time of 2 months, 17 months, and 63 months after RT using a validated questionnaire (Expanded Prostate Cancer Index Composite). A mean score change of >5 points was defined as clinically relevant.
For patients treated with a hydrogel spacer, mean bowel function and bother score changes of >5 points in comparison with baseline levels were found only at the end of RT (10-15 points; P<.01). No spacer patient reported moderate or big problems with his bowel habits overall. Mean bother score changes of 21 points at the end of RT, 8 points at 2 months, 7 points at 17 months, and 6 points at 63 months after RT were found for patients treated without a spacer. A bowel bother score change >10 points was found in 6% versus 32% (P<.01) at 17 months and in 5% versus 14% (P=.2) at 63 months with versus without a spacer.
The first 5-year quality of life results in a group of prostate cancer patients treated with a hydrogel spacer demonstrate excellent treatment tolerability, in particular regarding bowel problems. Further studies with dose-escalated or re-irradiation concepts can be encouraged.
评估使用水凝胶间隔物进行前列腺癌放射治疗（RT）后长达5年的生活质量变化。
在2010年至2011年期间，114例患者接受了前列腺外照射放疗；54例患者在放疗开始前接受了水凝胶注射。采用每次2Gy的分次照射，总剂量达76Gy（n = 96）或78Gy（n = 18，均使用水凝胶）。在放疗前、放疗最后一天以及放疗后2个月、17个月和63个月的中位时间，使用经过验证的问卷（扩展前列腺癌指数综合问卷）对患者进行调查。平均得分变化>5分被定义为具有临床相关性。
对于接受水凝胶间隔物治疗的患者，仅在放疗结束时发现与基线水平相比，肠道功能和困扰评分平均变化>5分（10 - 15分；P <.01）。没有间隔物的患者总体上没有报告中度或严重的肠道习惯问题。对于未使用间隔物治疗的患者，放疗结束时困扰评分平均变化21分，放疗后2个月8分，17个月7分，63个月6分。在17个月时，有间隔物与无间隔物的患者中，肠道困扰评分变化>10分的比例分别为6%和32%（P <.01）；在63个月时，这一比例分别为5%和14%（P =.2）。
一组接受水凝胶间隔物治疗的前列腺癌患者的首个5年生活质量结果显示出极佳的治疗耐受性，尤其是在肠道问题方面。可鼓励开展关于剂量递增或再照射概念的进一步研究。
