摘要
目的:探讨立体定向放疗(SBRT)治疗局限期前列腺癌的有效性与安全性。方法:选取2018年8月—2021年6月收治的局限期前列腺癌患者80例,随机分为试验组和对照组。试验组40例,平均年龄(70.34±8.38)岁,平均前列腺特异性抗原(PSA)水平(16.81±7.41)ng/mL,治疗方案7.25 Gy/次剂量分割,总剂量36.25 Gy,放疗5次,1~2周完成。对照组40例,平均年龄(71.23±6.78)岁,平均PSA水平(20.62±6.52)ng/mL,治疗方案1.8~2.0 Gy/次剂量分割,总剂量76~80 Gy,每周5次,7.5周完成。主要观察指标包括放射损伤、PSA、次要观察指标总生存期。结果:两组患者中位随访24个月,最长随访41个月,两组患者年龄、PSA、Gleason评分、T分期、去势治疗方式比较差异均无统计学意义(P>0.05)。早、晚期放疗不良反应主要为泌尿道及胃肠道不良反应,不良反应分级为1、2级;两组早期不良反应发生率及晚期泌尿道不良反应率相近;试验组晚期胃肠道不良反应发生率明显低于对照组(60.00%vs.82.50%,P=0.031)。结论:SBRT与常规分割调强放疗比较,SBRT治疗局限期前列腺癌患者耐受良好,治疗时间短,PSA控制及早期不良反应相似,晚期胃肠道不良反应发生率更低。
Objective:To investigate the efficacy and safety of stereotactic body radiotherapy(SBRT)in the treatment of localized prostate cancer.Methods:From August 2018 to June 2021,80 patients with prostate cancer in our hospital were randomly divided into radiotherapy group and control group.There were 40 patients in the experimental group,with an average age of(70.34±8.38)years,an average prostate specific antigen(PSA)level of(16.81±7.41)ng/mL,a treatment regimen of 7.25 Gy/time,a total dose of 36.25 Gy,5 times of radiotherapy,completed in 1-2 weeks.There were 40 patients in the control group,with an average age of(71.23±6.78)years,an average PSA level of(20.62±6.52)ng/mL,a treatment regimen of 1.8-2.0 Gy/dose division,and a total dose of 76-80 Gy,5 days of continuous radiotherapy and completed it in 7.5 weeks.The main outcome measures included radiation injury,PSA evaluation and secondary outcome measure was overall survival(OS).Results:The median follow-up was 24 months and the longest was 41 months.There was no significant difference in age,PSA,Gleason score,T stage or castration treatment between the two groups(P>0.05).The main adverse reactions of early and late radiotherapy between the two groups were urinary tract adverse reactions and gastrointestinal adverse reactions.The adverse reactions were classified as grade 1 and 2,and there were no grade 3 adverse reactions.The incidence of grade 1-2 early adverse reactions and late urinary adverse reactions were similar between the experimental group and the control group.The incidence of grade 1-2 late gastrointestinal toxicity in the experimental group was significantly lower than that in the control group(60.00%vs.82.50%,P=0.031).Conclusion:Compared with intensity-modulated radiation therapy,stereotactic radiotherapy is well tolerated,and its treatment time is short.PSA control and early adverse reactions of two groups are similar,but the rate of late gastrointestinal adverse reactions of the experimental group is lower.
作者
宋彦平
鲜鹏
罗宏
戴君勇
李元
白玉
SONG Yanping;XIAN Peng;LUO Hong;DAI Junyong;LI Yuan;BAI Yu(Department of Urology,Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment,Chongqing University Cancer Hospital,Chongqing,400030,China)
出处
《临床泌尿外科杂志》
CAS
2022年第6期409-412,417,共5页
Journal of Clinical Urology
基金
重庆市科卫联合医学科研项目面上项目(No:2021MSXM135)。
关键词
超大分割
立体定向放射治疗
前列腺癌
super large segmentation
stereotactic body radiotherapy
prostate cancer
