局部前列腺癌调强适形放疗（TomoTherapy）的长期疗效：一项回顾性研究。
Long-term outcome of hypofractionated intensity-modulated radiotherapy using TomoTherapy for localized prostate cancer: A retrospective study.
机构信息
Department of Radiation Oncology, Gunma University Graduate School of Medicine, Showa-machi, Maebashi, Gunma, Japan.
Oncology Center, Hidaka Hospital, Nakao-machi, Takasaki, Gunma, Japan.
出版信息
PLoS One. 2019 Feb 26;14(2):e0211370. doi: 10.1371/journal.pone.0211370. eCollection 2019.
BACKGROUND
Recently, the clinical outcome of prostate cancer treated by hypofractionated radiation therapy has been reported. However, there are few reports from Japan. In Hidaka Hospital, hypofractionated intensity-modulated radiotherapy (HIMRT) for prostate cancer was initiated in 2007. The purpose of this study is to analyze the long-term outcome.
METHODS
Ninety-two patients with localized prostate cancer treated with HIMRT at Hidaka Hospital between 2007 and 2009 were retrospectively analyzed. HIMRT was delivered using TomoTherapy. The prescription dose was 66 Gy at 95% of the PTV in 22 fractions performed 3 days a week over 7 weeks in all patients. The overall survival rate, biochemical relapse-free rate, and acute and late toxicities were evaluated.
RESULTS
The median follow-up duration was 78 (range 14-100) months. The median age at the start of the HIMRT was 72 (range 46-84) years. The disease characteristics were as follows: stage T1c, 45; T2a, 20; T2b, 5; T2c, 1; T3a, 13; T3b, 6; T4, 2; Gleason score 6, 13; 7, 44; 8, 20; 9, 15; 10, 0; pretreatment PSA ≤10 ng/mL, 42; 10 to ≤20, 27; and >20, 23. According to the D'Amico classification system, 10, 37, and 45 patients were classified as low-risk, intermediate-risk, and high-risk. The overall survival rate, the cause-specific survival rate, and the biochemical relapse-free rate at 5 years was 94.7%, 100% and 98.9%, respectively. Severe acute toxicity (grade 3 or more) was not observed. The late urinary toxicity was 52.2% in grade 0, 28.3% in grade 1, 19.6% in grade 2, and 2.2% in grade 3. The late rectal toxicity was 78.3% in grade 0, 7.6% in grade 1, 9.8% in grade 2, and 4.3% in grade 3.
CONCLUSIONS
The present study demonstrated that HIMRT using TomoTherapy for prostate cancer has a favorable outcome with tolerable toxicity.
背景
最近，有报道称采用低分割放射治疗的前列腺癌的临床结果。然而，来自日本的报道较少。在日高医院，2007 年开始采用低分割调强放疗（HIMRT）治疗前列腺癌。本研究的目的是分析长期结果。
方法
回顾性分析了 2007 年至 2009 年在日高医院接受 HIMRT 治疗的 92 例局限性前列腺癌患者。HIMRT 使用 TomoTherapy 进行。所有患者的处方剂量均为 66Gy，95%的 PTV，22 个分次，每周 3 次，共 7 周。评估总生存率、生化无复发生存率以及急性和迟发性毒性。
结果
中位随访时间为 78（14-100）个月。开始 HIMRT 时的中位年龄为 72（46-84）岁。疾病特征如下：T1c 期 45 例，T2a 期 20 例，T2b 期 5 例，T2c 期 1 例，T3a 期 13 例，T3b 期 6 例，T4 期 2 例，Gleason 评分 6 分 13 例，7 分 44 例，8 分 20 例，9 分 15 例，10 分 0 例，治疗前 PSA≤10ng/ml 42 例，10-20ng/ml 27 例，>20ng/ml 23 例。根据 D'Amico 分类系统，低危、中危和高危患者分别为 10、37 和 45 例。5 年总生存率、特异性生存率和生化无复发生存率分别为 94.7%、100%和 98.9%。未观察到严重急性毒性（≥3 级）。晚期尿毒性 0 级 52.2%，1 级 28.3%，2 级 19.6%，3 级 2.2%。晚期直肠毒性 0 级 78.3%，1 级 7.6%，2 级 9.8%，3 级 4.3%。
结论
本研究表明，采用 TomoTherapy 的前列腺癌低分割放疗具有良好的疗效和可耐受的毒性。
Zotero 插件