Duttenhaver J R, Shipley W U, Perrone T, Verhey L J, Goitein M, Munzenrider J E, Prout G R, Parkhurst E C, Suit H D
Cancer. 1983 May 1;51(9):1599-604. doi: 10.1002/1097-0142(19830501)51:9<1599::aid-cncr2820510908>3.0.co;2-o.
A total of 180 patients with carcinoma of the prostate limited to the pelvis were treated with one of two external beam irradiation techniques between 1972 and 1979. One hundred and sixteen patients were treated with conventional pelvic megavoltage x-ray therapy. Sixty-four patients were treated with combined pelvic x-ray therapy plus a perineal proton beam boost to a carefully defined prostatic tumor volume. A 160 MeV proton beam has been modified to irradiate patients with localized tumors by using conventional treatment schedules. This proton beam has the physical advantage over megavoltage x-rays of reducing the dose to normal tissues adjacent to the tumor volume. By using the proton beam boost we have delivered an increased prostatic tumor dose of 500 to 700 cGy without increasing treatment morbidity at all. The two groups are actuarially analyzed for patient survival, disease-free survival and local recurrence-free survival, and thus far, no significant differences have been noted. Because of the minimal complications observed in the proton group despite a 10% increase in dose, a randomized clinical trial comparing these two treatment techniques is studied.
1972年至1979年间，共有180例局限于盆腔的前列腺癌患者接受了两种外照射技术中的一种治疗。116例患者接受了传统盆腔兆伏级X线治疗。64例患者接受了盆腔X线联合治疗，外加会阴质子束对精心界定的前列腺肿瘤体积进行增敏照射。通过使用传统治疗方案，已对160兆电子伏特的质子束进行了改进，以照射局部肿瘤患者。这种质子束相对于兆伏级X线具有物理优势，即能减少肿瘤体积附近正常组织的剂量。通过使用质子束增敏照射，我们在完全不增加治疗并发症的情况下，将前列腺肿瘤剂量增加了500至700厘戈瑞。对两组患者的生存情况、无病生存率和无局部复发生存率进行了精算分析，到目前为止，尚未发现显著差异。由于质子组尽管剂量增加了10%，但观察到的并发症极少，因此正在开展一项比较这两种治疗技术的随机临床试验。
