Zamboglou Constantinos, Spohn Simon K B, Adebahr Sonja, Huber Maria, Kirste Simon, Sprave Tanja, Gratzke Christian, Chen Ronald C, Carl Ernst Günther, Weber Wolfgang A, Mix Michael, Benndorf Matthias, Wiegel Thomas, Baltas Dimos, Jenkner Carolin, Grosu Anca L
Department of Radiation Oncology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany.
German Cancer Consortium (DKTK), Partner Site Freiburg, 79106 Freiburg, Germany.
Cancers (Basel). 2021 Nov 18;13(22):5795. doi: 10.3390/cancers13225795.
Technical advances in radiotherapy (RT) treatment planning and delivery have substantially changed RT concepts for primary prostate cancer (PCa) by (i) enabling a reduction of treatment time, and by (ii) enabling safe delivery of high RT doses. Several studies proposed a dose-response relationship for patients with primary PCa and especially in patients with high-risk features, as dose escalation leads to improved tumor control. In parallel to the improvements in RT techniques, diagnostic imaging techniques like multiparametric magnetic resonance imaging (mpMRI) and positron-emission tomography targeting prostate-specific-membrane antigen (PSMA-PET) evolved and enable an accurate depiction of the intraprostatic tumor mass for the first time. The HypoFocal-SBRT study combines ultra-hypofractionated RT/stereotactic body RT, with focal RT dose escalation on intraprostatic tumor sides by applying state of the art diagnostic imaging and most modern RT concepts. This novel strategy will be compared with moderate hypofractionated RT (MHRT), one option for the curative primary treatment of PCa, which has been proven by several prospective trials and is recommended and carried out worldwide. We suspect an increase in relapse-free survival (RFS), and we will assess quality of life in order to detect potential changes.
放射治疗（RT）治疗计划与实施方面的技术进步，通过以下方式极大地改变了原发性前列腺癌（PCa）的RT理念：（i）能够缩短治疗时间；（ii）能够安全地给予高剂量RT。多项研究提出了原发性PCa患者，尤其是具有高危特征患者的剂量反应关系，因为剂量递增可改善肿瘤控制。与RT技术的改进同时，多参数磁共振成像（mpMRI）和靶向前列腺特异性膜抗原的正电子发射断层扫描（PSMA-PET）等诊断成像技术得到发展，并首次能够准确描绘前列腺内肿瘤块。HypoFocal-SBRT研究将超分割RT/立体定向体部RT与通过应用先进诊断成像和最现代RT理念对前列腺内肿瘤部位进行局部RT剂量递增相结合。这种新策略将与中度分割RT（MHRT）进行比较，MHRT是PCa根治性初始治疗的一种选择，已被多项前瞻性试验证实，并在全球范围内得到推荐和实施。我们怀疑无复发生存期（RFS）会增加，并且我们将评估生活质量以检测潜在变化。
