Department of Radiation Oncology, CyberKnife and Radiation Therapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener St 62, 50937, Cologne, Germany.
Department of Urology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener St 62, 50937, Cologne, Germany.
Strahlenther Onkol. 2023 Jun;199(6):574-584. doi: 10.1007/s00066-023-02060-2. Epub 2023 Mar 17.
The outcome of radiotherapy (RT) for prostate cancer (PCA) depends on the delivered dose. While the evidence for dose-escalated RT up to 80 gray (Gy) is well established, there have been only few studies examining dose escalation above 80 Gy. We initiated the present study to assess the safety of dose escalation up to 84 Gy.
In our retrospective analysis, we included patients who received dose-escalated RT for PCA at our institution between 2016 and 2021. We evaluated acute genitourinary (GU) and gastrointestinal (GI) toxicity as well as late GU and GI toxicity.
A total of 86 patients could be evaluated, of whom 24 patients had received 80 Gy and 62 patients 84 Gy (35 without pelvic and 27 with pelvic radiotherapy). Regarding acute toxicities, no > grade 2 adverse events occurred. Acute GU/GI toxicity of grade 2 occurred in 12.5%/12.5% of patients treated with 80 Gy, in 25.7%/14.3% of patients treated with 84 Gy to the prostate only, and in 51.9%/12.9% of patients treated with 84 Gy and the pelvis included. Late GU/GI toxicity of grade ≥ 2 occurred in 4.2%/8.3% of patients treated with 80 Gy, in 7.1%/3.6% of patients treated with 84 Gy prostate only, and in 18.2%/0% of patients treated with 84 Gy pelvis included (log-rank test p = 0.358).
We demonstrated that dose-escalated RT for PCA up to 84 Gy is feasible and safe without a significant increase in acute toxicity. Further follow-up is needed to assess late toxicity and survival.
前列腺癌（PCA）放射治疗（RT）的结果取决于所给予的剂量。虽然已经有充分的证据证明高达 80 戈瑞（Gy）的剂量递增 RT 是有效的，但仅有少数研究检查了 80 Gy 以上的剂量递增。我们发起了本研究，以评估高达 84 Gy 的剂量递增的安全性。
在我们的回顾性分析中，我们纳入了在我们机构接受 PCA 剂量递增 RT 的患者。我们评估了急性泌尿生殖系统（GU）和胃肠道（GI）毒性以及晚期 GU 和 GI 毒性。
共评估了 86 例患者，其中 24 例接受了 80 Gy，62 例接受了 84 Gy（35 例无骨盆放疗，27 例有骨盆放疗）。关于急性毒性，没有发生 > 2 级的不良事件。80 Gy 治疗组有 12.5%/12.5%的患者发生 2 级急性 GU/GI 毒性，84 Gy 治疗组（仅前列腺）有 25.7%/14.3%的患者发生 2 级急性 GU/GI 毒性，84 Gy 治疗组（包括骨盆）有 51.9%/12.9%的患者发生 2 级急性 GU/GI 毒性。80 Gy 治疗组有 4.2%/8.3%的患者发生≥2 级晚期 GU/GI 毒性，84 Gy 治疗组（仅前列腺）有 7.1%/3.6%的患者发生≥2 级晚期 GU/GI 毒性，84 Gy 治疗组（包括骨盆）有 18.2%/0%的患者发生≥2 级晚期 GU/GI 毒性（对数秩检验 p=0.358）。
我们证明了高达 84 Gy 的 PCA 剂量递增 RT 是可行和安全的，没有明显增加急性毒性。需要进一步随访以评估晚期毒性和生存率。
