Department of Radiation Oncology, Geneva University Hospital, Geneva, Switzerland.
Faculty of Medicine, Geneva University, Switzerland.
Cancer Treat Rev. 2018 Jan;62:91-96. doi: 10.1016/j.ctrv.2017.11.004. Epub 2017 Nov 14.
Postoperative external beam radiation therapy (EBRT) is a validated treatment option in the adjuvant setting for prostate cancer patients with aggressive pathological features following radical prostatectomy (RP) or as salvage modality in patients with biochemical recurrence after RP. Contemporary randomized phase III trials have provided evidence for using hypofractionation in the definitive treatment setting as an alternative to standard fractionated regimens. Biomathematical modeling for prostate cancer fractionated EBRT associated with widely available refined treatment delivery techniques such as volumetric modulated-arc therapy with image-guided RT may improve the therapeutic ratio. Nevertheless, the role of hypofractionation in the postoperative setting still remains investigational. In this systematic review of the literature we reviewed the role of hypofractionation for postoperative EBRT in the adjuvant or salvage setting in prostate cancer patients previously treated by RP. A favorable acute toxicity profile with, at least, as good biochemical control rates with hypofractionation has been suggested. And yet conflicting results have been reported concerning long-term genitourinary late toxicity. Prospective studies are eagerly awaited to assess the role of hypofractionation in the postoperative setting.
术后外束放射治疗（EBRT）是根治性前列腺切除术（RP）后具有侵袭性病理特征的前列腺癌患者辅助治疗中的一种经证实的治疗选择，或是 RP 后生化复发患者的挽救治疗方式。当代随机 III 期临床试验为在确定性治疗中使用分割次数较少的方案提供了证据，将其作为标准分割方案的替代方案。前列腺癌分割 EBRT 的生物数学模型与广泛可用的精细治疗技术相结合，如容积调强弧形治疗和图像引导放疗，可能会提高治疗效果。然而，分割次数较少在术后治疗中的作用仍在研究中。在对文献的系统回顾中，我们回顾了在接受 RP 治疗的前列腺癌患者的辅助或挽救性治疗中，术后 EBRT 采用分割次数较少方案的作用。有研究提示，这种方案具有较好的急性毒性特征，至少与标准分割方案一样可以获得较好的生化控制率。然而，关于长期泌尿生殖系统迟发性毒性方面的结果却存在争议。迫切需要前瞻性研究来评估分割次数较少在术后治疗中的作用。
