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放射治疗方法会影响前列腺癌患者的急性毒性吗?四种放射技术的比较。

Does the radiation approach affect acute toxicity in prostate cancer patients? A comparison of four radiation techniques.

作者信息

Poźniak-Balicka Róża, Chomiak Beata, Wośkowiak Piotr, Nowicki Norbert, Bojarski Jacek, Salagierski Maciej

机构信息

Faculty of Medicine and Health Sciences, Department of Radiotherapy, Zielona Góra, Poland.

Faculty of Medicine and Health Sciences, Department of Urology, Zielona Góra, Poland.

出版信息

Cent European J Urol. 2020;73(3):295-299. doi: 10.5173/ceju.2020.0091. Epub 2020 Aug 18.

Abstract

INTRODUCTION

Prostate cancer is treated with increasingly sophisticated radiation techniques. The aim of the study is to compare acute toxicity in patients managed with different therapeutic modalities.

MATERIAL AND METHODS

A total of 60 patients irradiated between 2012 and 2016 were analyzed: A. conformal 3D - 11, B. intensity-modulated radiation therapy (IMRT) 20, C. image-guided radiation therapy (IGRT) - 19 and D. volumetric modulated arc therapy (VMAT) - 10. Patients' age ranged from 46 to 85 years (median 70.5), prostate-specific antigen values at the time of diagnosis were in the range of 3.54-154 ng/ml (median 15.9). Acute toxicity from the genitourinary (GU) and gastrointestinal (GI) tracts according to the European Organization for Research and Treatment of Cancer (EORTC) /Radiation Therapy Oncology Group (RTOG) grading system were assessed.

RESULTS

All irradiation techniques were well tolerated and neither 3 nor 4 degrees acute toxicity was observed. Importantly, IGRT and IMRT did not lead to Grade 2 GI acute toxicity. There was no relationship between the severity of GU acute toxicity depending on the irradiation technique used (p = 0.8), but a trend towards a significant relationship was noted for GI acute toxicity (p = 0.05).

CONCLUSIONS

All assessed irradiation methods do not lead to severe acute adverse effects. Importantly, patients treated with IGRT and IMRT had only minor GI toxicity.

摘要

引言

前列腺癌采用日益复杂的放射技术进行治疗。本研究的目的是比较采用不同治疗方式的患者的急性毒性。

材料与方法

分析了2012年至2016年间接受放疗的60例患者:A.适形3D放疗 - 11例,B.调强放射治疗(IMRT) - 20例,C.图像引导放射治疗(IGRT) - 19例,D.容积调强弧形治疗(VMAT) - 10例。患者年龄在46至85岁之间(中位数70.5岁),诊断时前列腺特异性抗原值在3.54 - 154 ng/ml范围内(中位数15.9)。根据欧洲癌症研究与治疗组织(EORTC)/放射治疗肿瘤学组(RTOG)分级系统评估泌尿生殖系统(GU)和胃肠道(GI)的急性毒性。

结果

所有放射技术耐受性良好,未观察到3级或4级急性毒性。重要的是,IGRT和IMRT未导致2级胃肠道急性毒性。根据所使用的放射技术,GU急性毒性的严重程度之间没有关系(p = 0.8),但胃肠道急性毒性存在显著关系的趋势(p = 0.05)。

结论

所有评估的放射方法均未导致严重的急性不良反应。重要的是,接受IGRT和IMRT治疗的患者只有轻微的胃肠道毒性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02ab/7587475/a91d8de891dd/CEJU-73-0091-g001.jpg

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