Department of Oncology, University of Alberta, 11560 University Ave, Edmonton, AB T6G 1Z2, Canada.
Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta, 11560 University Ave, Edmonton, AB T6G 1Z2, Canada.
Curr Oncol. 2023 Jul 10;30(7):6587-6595. doi: 10.3390/curroncol30070483.
This study retrospectively reviewed data from men with localized prostate cancer treated with external beam radiotherapy (EBRT). We identified 359 men with localized prostate cancer treated with curative EBRT at the Cross Cancer Institute between 2010-2011. The volume of seminal vesicles (SVs) treated as well as dose values were extracted. These volumes were compared to gold standard contours drawn by a trained expert based on consensus European Society for Radiotherapy and Oncology (ESTRO) contouring guidelines. Patient and tumor characteristics were extracted for these patients. Memorial Sloan Kettering prostate cancer nomogram was used to assign a predicted risk of SV involvement for each patient based on baseline tumor characteristics. In patients with a predicted risk of SV involvement greater than 15% ( = 184), 86.5% (SD = 18.6) of the base of the SVs were treated with EBRT, compared to 66.7% (SD = 32.6) for patients with a predicted risk of SV involvement less than 15% ( = 175, < 0.0001). Similarly, the mean percentage of proximal and total SV volumes treated with EBRT was 75.6% (SD = 24.4) and 68.7% (SD = 26.0) for patients with a predicted risk of SV involvement of greater than 15%, compared to 50.3% (SD = 31.0, < 0.0001) and 41.0% (SD = 27.8, < 0.0001) for patients with a risk of less than 15%. The results indicate that all parts of the SVs are more likely to be contoured in men with >15% risk of SV involvement than those with <15% risk. However, radiation oncologists still contour a high percentage of SVs in men with <15% risk of SV involvement, suggesting that there may be over-treatment of SVs that increases the risk of rectal or bladder toxicity.
这项研究回顾性分析了接受外照射放疗（EBRT）治疗的局限性前列腺癌男性患者的数据。我们在 2010-2011 年间，从 Cross Cancer Institute 治疗局限性前列腺癌的 359 名男性患者中识别出符合条件的患者。提取了治疗精囊（SVs）的体积和剂量值。这些体积与根据欧洲放射治疗和肿瘤学学会（ESTRO）共识勾画指南由一位训练有素的专家绘制的金标准轮廓进行了比较。为这些患者提取了患者和肿瘤特征。根据基线肿瘤特征，使用 Memorial Sloan Kettering 前列腺癌诺模图为每位患者分配 SV 受累的预测风险。在预测 SV 受累风险大于 15%（=184）的患者中，86.5%（SD=18.6）的 SV 基底接受了 EBRT 治疗，而预测 SV 受累风险小于 15%（=175）的患者中这一比例为 66.7%（SD=32.6）（=0.0001）。类似地，对于预测 SV 受累风险大于 15%的患者，接受 EBRT 的近端和总 SV 体积的平均百分比分别为 75.6%（SD=24.4）和 68.7%（SD=26.0），而预测 SV 受累风险小于 15%的患者中这一比例分别为 50.3%（SD=31.0，<0.0001）和 41.0%（SD=27.8，<0.0001）。结果表明，与预测 SV 受累风险小于 15%的患者相比，预测 SV 受累风险大于 15%的患者更有可能对 SVs 的所有部位进行勾画。然而，放射肿瘤学家仍然对预测 SV 受累风险小于 15%的患者勾画 SVs 的高比例，这表明可能存在过度治疗 SVs 从而增加直肠或膀胱毒性的风险。
