前列腺癌术后不同分割模式放射治疗急性不良反应初步研究  

A preliminary toxicity study of different dose fractionation regimens in postoperative radiotherapy for prostate cancer

作　　者：秦尚彬[1] 高献书[1] 李洪振[1] 顾晓斌[1] 李晓颖[1] 亓昕[1] 任雪盈 Qin Shangbin;Gao Xianshu;Li Hongzhen;Gu Xiaoying;Li Xiaoying;Qi Xin;Ren Xueying(Prostate Cancer Radiotherapy Center,Department of Radiation Oncology,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院放疗科前列腺癌放疗中心,100034

出　　处：《中华放射肿瘤学杂志》2018年第7期665-668,共4页Chinese Journal of Radiation Oncology

摘　　要：目的 初步比较前列腺癌术后不同分割模式放疗不良反应。方法 收集我院2011-2017年间接受前列腺癌术后中等分割（62.75 Gy分25次,2.51 Gy/次）和术后常规分割（72 Gy分36次,2 Gy/次）放疗患者资料。所有患者均接受了调强放射治疗（IMRT）,每日图像引导放射治疗（IGRT）。采用倾向评分匹配法（PSM）将两组分别匹配35例,匹配因素包括年龄、照射范围、内分泌治疗、手术—放疗间隔时间、以及合并症（糖尿病、高血压）。不良反应评价采用北美放射肿瘤协作组（RTOG）急性不良反应评价标准。差异行Fisher′s精确概率法检验。结果 113例患者纳入分析,其中中等分割组41例,常规分割组72例。中位随访时间分别为5.6、45.0个月。中等分割与常规分割组2级急性胃肠、泌尿不良反应分别为7%与7%（P=1.000）、15%与17%（P=0.847）。PSM匹配后两组2级急性胃肠、泌尿不良反应分别为9%与11%（P=0.814）、14%与11%（P=0.670）。无≥3级急性胃肠、泌尿不良反应。结论 初步结果显示前列腺癌术后中等分割与常规分割相比未增加患者急性胃肠、泌尿不良反应风险。Objective To compare the toxicity between different dose fractionation regimens in postoperative radiotherapy for prostate cancer. Methods Patients with prostate cancer who received postoperative radiotherapy with moderate hypo-fractionation （62.75 Gy in 25 fractions, 2.51 Gy per fraction） or conventional fractionation （72 Gy in 36 fractions, 2 Gy per fractions） in our hospital from 2011 to 2017 were enrolled as subjects. All patients received intensity-modulated radiotherapy and daily cone-beam computed tomography image-guided radiotherapy. According to the propensity score matching （PSM） method, 35 patients treated with moderately hypo-fractionated radiotherapy were matched to 35 patients treated with conventionally fractionated radiotherapy based on age, irradiated volume, hormonal therapy, interval between surgery and radiotherapy, and comorbidities （diabetes and hypertension）. Toxicity was evaluated according to Radiation Therapy Oncology Group criteria. Comparison was made by the Fisher′s exact probability test. Results One hundred and thirteen patients, consisting of forty-one in moderate hypo-fractionation group and seventy-two in conventional fractionation group, were enrolled as subjects. The median follow-up time in the two groups was 5.6 and 45.0 months, respectively. There were no significant differences in incidence rates of grade 2 acute gastrointestinal （GI） or genitourinary （GU） toxicity between the two groups （7% vs. 7%, P=1.000;15% vs. 17%, P=0.847）. After PSM, there were still no significant differences in incidence rates of grade 2 acute GI or GU toxicity between the two groups （9% vs. 11%, P=0.814;14% vs. 11%, P=0.670）. None of patients reported≥grade 3 GI or GU toxicity. Conclusions Preliminary results show that moderate hypo-fractionation, compared with conventional fractionation, does not increase the risk of acute GI or GU toxicity in patients undergoing postoperative radiotherapy for prostate cancer.

关 键 词：前列腺肿瘤/术后放射疗法 放射疗法 中等分割 放射疗法 常规分割 

分 类 号：R737.25[医药卫生—肿瘤] R730.55[医药卫生—临床医学]