Department of Radiology, Aichi Medical University Hospital, Nagakute, Japan;
Department of Radiation Oncology, Toyota Memorial Hospital, Toyota, Japan.
Anticancer Res. 2021 May;41(5):2523-2531. doi: 10.21873/anticanres.15030.
BACKGROUND/AIM: To compare five radiotherapy methods for prostate cancer.
During 2005-2018, the data of patients with non-metastatic prostate cancer were retrospectively analysed. Patients were treated with high-dose-rate brachytherapy (HDR-BT); low-dose-rate brachytherapy (LDR-BT); or external-beam radiotherapy (EBRT), including conventionally fractionated radiotherapy (CFRT), moderate-hypofractionated radiotherapy (MHRT), and ultra-hypofractionated radiotherapy (UHRT).
In total, 496 patients (149, HDR-BT; 100, LDR-BT; 100, CFRT; 97, MHRT, and 50, UHRT) with a median follow-up of 4.3 years were enrolled. The incidence of grade ≥2 acute genitourinary toxicities was significantly lower with HDR-BT (p<0.001) than with any other radiotherapy. The cumulative incidence of late grade ≥2 genitourinary toxicities was the highest with UHRT and significantly higher (p=0.005) with UHRT than with HDR-BT. Higher symptom score peaks were noted 4 weeks after therapy for LDR-BT than for EBRT.
Physician-recorded toxicities were slightly lower with HDR-BT and patient-reported outcomes tended to be worse with LDR-BT.
背景/目的：比较五种前列腺癌放疗方法。
回顾性分析 2005 年至 2018 年间非转移性前列腺癌患者的数据。患者接受高剂量率近距离治疗（HDR-BT）；低剂量率近距离治疗（LDR-BT）；或外照射放疗（EBRT），包括常规分割放疗（CFRT）、中分割放疗（MHRT）和超分割放疗（UHRT）。
共纳入 496 例患者（149 例 HDR-BT；100 例 LDR-BT；100 例 CFRT；97 例 MHRT 和 50 例 UHRT），中位随访时间为 4.3 年。HDR-BT 组急性泌尿生殖系统毒性≥2 级的发生率显著低于其他任何放疗组（p<0.001）。晚期泌尿生殖系统毒性≥2 级的累积发生率以 UHRT 最高，且 UHRT 显著高于 HDR-BT（p=0.005）。LDR-BT 治疗后 4 周时，症状评分峰值高于 EBRT。
医生记录的毒性略低于 HDR-BT，患者报告的结果往往更差 LDR-BT。
