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1.5T磁共振引导下立体定向体部放射治疗局限性前列腺癌:临床医生和患者报告结局的初步临床结果

1.5T Magnetic Resonance-Guided Stereotactic Body Radiotherapy for Localized Prostate Cancer: Preliminary Clinical Results of Clinician- and Patient-Reported Outcomes.

作者信息

Poon Darren M C, Yuan Jing, Wong Oi-Lei, Yang Bin, Chiu Sin-Ting, Cheung Kin-Yin, Chiu George, Yu Siu-Ki

机构信息

Comprehensive Oncology Centre, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong, China.

Medical Physics and Research Department, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong, China.

出版信息

Cancers (Basel). 2021 Sep 28;13(19):4866. doi: 10.3390/cancers13194866.

Abstract

BACKGROUND

Magnetic resonance-guided stereotactic body radiotherapy (MRgSBRT) offers the potential for achieving better prostate cancer (PC) treatment outcomes. This study reports the preliminary clinical results of 1.5T MRgSBRT in localized PC, based on both clinician-reported outcome measurement (CROM) and patient-reported outcome measurement (PROM).

METHODS

Fifty-one consecutive localized PC patients were prospectively enrolled with a median follow-up of 199 days. MRgSBRT was delivered in five fractions of 7.25-8 Gy with daily online adaptation. Clinician-reported gastrointestinal (GI) and genitourinary (GU) adverse events based on the Common Terminology Criteria for Adverse Events (CTCAE) Scale v. 5.0 were assessed. The Expanded Prostate Cancer Index Composite Questionnaire was collected at baseline, 1 month, and every 3 months thereafter. Serial prostate-specific antigen measurements were longitudinally recorded.

RESULTS

The maximum cumulative clinician-reported grade ≥ 2 acute GU and GI toxicities were 11.8% (6/51) and 2.0% (1/51), respectively, while grade ≥ 2 subacute GU and GI toxicities were 2.3% (1/43) each. Patient-reported urinary, bowel, and hormonal domain summary scores were reduced at 1 month, then gradually returned to baseline levels, with the exception of the sexual domain. Domain-specific subscale scores showed similar longitudinal changes. All patients had early post-MRgSBRT biochemical responses.

CONCLUSIONS

The finding of low toxicity supports the accumulation of clinical evidence for 1.5T MRgSBRT in localized PC.

摘要

背景

磁共振引导的立体定向体部放射治疗(MRgSBRT)为实现更好的前列腺癌(PC)治疗效果提供了可能。本研究报告了基于临床医生报告结局测量(CROM)和患者报告结局测量(PROM)的1.5T MRgSBRT治疗局限性PC的初步临床结果。

方法

前瞻性纳入51例连续的局限性PC患者,中位随访时间为199天。MRgSBRT分5次给予,每次7.25 - 8 Gy,并进行每日在线适应性调整。根据不良事件通用术语标准(CTCAE)第5.0版评估临床医生报告的胃肠道(GI)和泌尿生殖系统(GU)不良事件。在基线、1个月及此后每3个月收集扩展前列腺癌指数综合问卷。纵向记录系列前列腺特异性抗原测量值。

结果

临床医生报告的最高累积≥2级急性GU和GI毒性分别为11.8%(6/51)和2.0%(1/51),而≥2级亚急性GU和GI毒性均为2.3%(1/43)。患者报告的泌尿、肠道和激素领域总结评分在1个月时降低,然后逐渐恢复到基线水平,但性功能领域除外。特定领域的子量表评分显示出类似的纵向变化。所有患者在MRgSBRT后均有早期生化反应。

结论

低毒性的发现支持了1.5T MRgSBRT治疗局限性PC的临床证据积累。

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