Line Krhili S, Créhange G, Albert-Dufrois H, Guimas V, Minsat M, Supiot S
Département d'oncologie radiothérapie, Institut Curie, 75005 Paris, France.
Département d'oncologie radiothérapie, Institut Curie, 75005 Paris, France; Département d'oncologie radiothérapie, Institut Curie, 35, rue Dailly, 92210 Saint-Cloud, France; Centre de protonthérapie, Institut Curie, Université Paris Sud, 15, rue Georges Clemenceau, 91400 Orsay, France.
Cancer Radiother. 2019 Oct;23(6-7):503-509. doi: 10.1016/j.canrad.2019.07.139. Epub 2019 Aug 27.
There are many treatment options for localized prostate cancers, including active surveillance, brachytherapy, external beam radiotherapy, and radical prostatectomy. Quality of life remains a primary objective in the absence of superiority of one strategy over another in terms of specific survival with similar long-term biochemical control rates. Despite a significant decrease in digestive and urinary toxicities thanks to IMRT and IGRT, external radiotherapy remains a treatment that lasts approximately 2 months or 1.5 months, when combined with a brachytherapy boost. Given the specific radiosensitivity of this tumor, several randomized studies have shown that a hypofractionated scheme is not inferior in terms of biochemical control and toxicities, allowing to divide the number of fractions by a factor 2 to 8. Given that SBRT becomes a validated therapeutic option for a selected population of patients with localized prostate cancer, extreme hypofractionation is becoming a strong challenger of conventional external radiotherapy or brachytherapy.
对于局限性前列腺癌有多种治疗选择，包括主动监测、近距离放射治疗、外照射放疗和根治性前列腺切除术。在特定生存率方面没有一种策略优于另一种且长期生化控制率相似的情况下，生活质量仍然是主要目标。尽管调强放疗（IMRT）和图像引导放疗（IGRT）使消化和泌尿毒性显著降低，但外照射放疗仍是一种持续约2个月的治疗，或与近距离放射治疗强化联合时持续约1.5个月。鉴于这种肿瘤的特定放射敏感性，多项随机研究表明，在生化控制和毒性方面，大分割方案并不逊色，可将分次剂量减少2至8倍。鉴于立体定向体部放疗（SBRT）已成为选定的局限性前列腺癌患者群体的有效治疗选择，超高度大分割正成为传统外照射放疗或近距离放射治疗的有力挑战者。
