Sharma R, Chuba P J, Duclos M, Forman J D
Department of Radiation Oncology, Wayne State University, Karmanos Cancer Institute, Detroit, MI 48201, USA.
Radiology. 1997 Jul;204(1):211-2. doi: 10.1148/radiology.204.1.9205249.
To compare the volumes of normal tissue irradiation and toxicity in patients treated with definitive radiation therapy or postprostatectomy radiation therapy.
Results were analyzed prospectively in 49 patients who underwent definitive or postprostatectomy radiation therapy after three-dimensional conformal treatment planning. Dose-volume histograms and the effective area irradiated were analyzed. Patient charts were reviewed and scored for acute and chronic toxicity. The mean bladder volume was 200 mL in the definitive group and 226 mL in the postprostatectomy group. The mean rectal volume was 87 mL in the definitive group and 81 mL in the postprostatectomy group.
The dose to 25% of the rectal volume was 91% and 86% in the definitive and postprostatectomy groups, respectively. The dose to 25% of the bladder volume was 89% in the definitive group and 82% in the postprostatectomy group. The incidence of acute and chronic gastrointestinal and chronic genitourinary toxicity was similar in both groups, but acute genitourinary toxicity in the postprostatectomy group was significantly lower (P = .026). The volume of normal tissue irradiated was similar in both groups. Also, similar doses were delivered to the normal tissue.
Differences in acute genitourinary toxicity are most likely secondary to radiation-induced prostatitis. Postprostatectomy radiation therapy is safe and is not associated with increased toxicity.
比较接受根治性放疗或前列腺切除术后放疗患者的正常组织照射体积和毒性。
对49例在三维适形治疗计划后接受根治性或前列腺切除术后放疗的患者进行前瞻性结果分析。分析剂量体积直方图和照射的有效面积。查阅患者病历并对急性和慢性毒性进行评分。根治性放疗组的平均膀胱体积为200 mL，前列腺切除术后放疗组为226 mL。根治性放疗组的平均直肠体积为87 mL，前列腺切除术后放疗组为81 mL。
根治性放疗组和前列腺切除术后放疗组中，直肠体积25%所接受的剂量分别为91%和86%。膀胱体积25%所接受的剂量，根治性放疗组为89%，前列腺切除术后放疗组为82%。两组急性和慢性胃肠道及慢性泌尿生殖系统毒性的发生率相似，但前列腺切除术后放疗组的急性泌尿生殖系统毒性显著更低（P = 0.026）。两组照射的正常组织体积相似。而且，给予正常组织的剂量也相似。
急性泌尿生殖系统毒性的差异很可能继发于放射性前列腺炎。前列腺切除术后放疗是安全的，且与毒性增加无关。
