Mandel Isidora King, Díaz Felipe Kovacic, García Lorena Vargas
Radiation Oncology, Clínica IRAM, Universidad Diego Portales Santiago, Chile.
Rep Pract Oncol Radiother. 2023 Jul 25;28(3):316-321. doi: 10.5603/RPOR.a2023.0043. eCollection 2023.
The objective was to report acute toxicity and quality of life in prostate cancer patients treated with definitive hypofractionated pelvic radiation therapy.
Patients were designated candidates for hypofractionated pelvic radiation therapy if biopsy or imaging studies evidenced unfavorable intermediate-risk, high-risk or node-positive disease. Patients were treated using a regimen of 44 Gy to the nodal areas and simultaneous integrated boost of 60 Gy to the prostate in 20 fractions with CBCT-based imaging and volumetric arc therapy (VMAT). Patient data was obtained retrospectively; acute gastrointestinal (GI) and genitourinary (GU) toxicity was classified per Common Terminology Criteria for Adverse Events (CTCAE) v5.0 and obtained from clinical records. Quality of life was surveyed via phone call using the European Organization for Research and Treatment of Cancer (EORTC) questionnaire QLQ-PR25.
78 patients were treated between May and December 2021. 83.33% of patients had high-risk disease, 16.67% had intermediate-risk disease, and 34.62% patients had node-positive disease. Median follow-up was 10.6 months. No patients presented acute grade >3 GI toxicity, and one patient presented grade 3 GU toxicity. 25.64% patients presented acute G2 GI toxicity and 17.95% patients presented acute G2 GU toxicity. 60.26% of patients responded to the EORTC-PR25 questionnaire. Mean scores for symptom scales were 11.26, 4.96 and 9.57 for Urinary Symptoms, Bowel Symptoms and Hormonal Treatment-Related Symptoms; mean scores for Sexual Activity and Functioning were 19.86 and 31.08, respectively.
Definitive hypofractionated pelvic radiation therapy has an acceptable acute toxicity and QoL profile in this series of patients, although longer follow-up is needed to properly evaluate short and long-term toxicity. Further follow-up and patient recruitment is ongoing.
目的是报告接受根治性大分割盆腔放疗的前列腺癌患者的急性毒性和生活质量。
如果活检或影像学研究证明为不良中危、高危或淋巴结阳性疾病，则将患者指定为大分割盆腔放疗的候选者。患者采用基于CBCT成像和容积弧形调强放疗（VMAT）的方案，对淋巴结区域给予44 Gy，同时对前列腺同步推量至60 Gy，分20次进行治疗。患者数据为回顾性获取；急性胃肠道（GI）和泌尿生殖系统（GU）毒性按照不良事件通用术语标准（CTCAE）v5.0进行分类，并从临床记录中获取。使用欧洲癌症研究与治疗组织（EORTC）问卷QLQ-PR25通过电话调查生活质量。
2021年5月至12月期间共治疗78例患者。83.33%的患者患有高危疾病，16.67%患有中危疾病，34.62%的患者有淋巴结阳性疾病。中位随访时间为10.6个月。没有患者出现急性3级以上GI毒性，1例患者出现3级GU毒性。25.64%的患者出现急性2级GI毒性，17.95%的患者出现急性2级GU毒性。60.26%的患者对EORTC-PR25问卷做出了回应。泌尿系统症状、肠道症状和激素治疗相关症状的症状量表平均得分分别为11.26、4.96和9.57；性功能和性活动的平均得分分别为19.86和31.08。
在这组患者中，根治性大分割盆腔放疗具有可接受的急性毒性和生活质量概况，尽管需要更长时间的随访来正确评估短期和长期毒性。进一步的随访和患者招募正在进行中。
