摘要
目的对比研究调强放疗(intensity modulated radiation therapy,IMRT)及三维适形放疗(three-di-mensional conformal radiation therapy,3D-CRT)治疗前列腺癌,评价两种放疗方法的优缺点。方法对39例采用IMRT的前列腺患者及33例采用3D-CRT的前列腺患者的放疗剂量、放疗前后血清前列腺癌特异性抗原(prostate specific antigen,PSA)水平、复发率、转移率、不良反应发生率及死亡率进行统计分析,分析生化复发与远处转移的相关性。结果 IMRT组的放疗剂量小于3D-CRT的放疗剂量,差异具有显著性(t=-4.153,P=0.042);放疗前,IMRT组及3D-CRT组血清PSA水平差异无显著性(t=-3.826,P=0.069);放疗后,IMRT组血清PSA水平小于3D-CRT组血清PSA水平,差异具有显著性(t=-7.202,P=0.021);IMRT组患者发生生化复发的时间及远处转移的时间均大于3D-CRT组,差异均具显著性(t=5.103,P=0.035;t=4.711,P=0.039)。IMRT患者的发生生化复发率为10.26%,远处转移率为10.26%,泌尿系统副反应发生率10.26%,直肠副反应发生率12.82%,死亡率6.06%,3D-CRT患者的发生生化复发率为21.21%,远处转移率为18.18%,泌尿系统副反应发生率12.12%,直肠副反应发生率18.18%,死亡率10.26%。发生远处转移的时间与发生生化复发的时间呈直线正相关(r=0.773,P=0.009)。结论 IMRT在剂量、疗效及不良反应方面均优于3D-CRT,而费用高于3D-CRT。
【Objective】To assess the advantage and disadvantage of intensity modulated radiation therapy（IMRT） and three-dimensional conformal radiation therapy（3D-CRT） treatment of prostate neoplasm.【Methods】72 patients with prostate carcinoma treated with radiotherapy were included in the retrospective analysis.Among them,39 patients received IMRT while the other 33 received 3D-CRT.The radiation dose,prostate specific antigen（PSA）,relapse rate,metastasis rate,side reaction and death rate of two methods were contrasted.Correlation between the time of relapse and the time of metastasis was analyzed.【Results】Compared with the 3D-CRT,the IMRT patients had decreased radiation dose（t =-4.153,P =0.042）,PSA of after radiotherapy（t =-7.202,P =0.021）.The time of relapse and metastasis of the IMRT patients were both significantly later than that of the3D-CRT patients（t =5.103,P = 0.035;t =4.711,P =0.039）.The incidence of relapse,metastasis,urinary toxicity,intestinal toxicity and death rate were 10.26%,10.26%,10.26%,12.82%,6.06% in IMRT patients,respectively.The incidence of relapse,metastasis,urinary toxicity,intestinal toxicity and death rate were 21.21%,18.18%,12.12%,18.18%,10.26% in the 3D-CRT patients,respectively.There were statistically significant correlation between relapse and metastasis time（r =0.773,P =0.009）.【Conclusions】The dose distribution,prognosis,side reaction of IMRT are better than those of 3D-CRT for prostate cancer.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2013年第19期97-100,共4页
China Journal of Modern Medicine
关键词
前列腺癌
放射疗法
三维适形
调强放疗
prostate neoplasm
radiotherapy
intensity modulated radiation therapy
three-dimensional conformal radiotherapy
