中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2009年
3期
209-213
,共5页
房辉%李晔雄%刘跃平%王维虎%金晶%王淑莲%宋永文%刘新帆%亓姝楠%刘清峰%戴建荣%余子豪
房輝%李曄雄%劉躍平%王維虎%金晶%王淑蓮%宋永文%劉新帆%亓姝楠%劉清峰%戴建榮%餘子豪
방휘%리엽웅%류약평%왕유호%금정%왕숙련%송영문%류신범%기주남%류청봉%대건영%여자호
前列腺肿瘤/放射疗法%放射疗法,大分割%放射疗法,调强%副反应
前列腺腫瘤/放射療法%放射療法,大分割%放射療法,調彊%副反應
전렬선종류/방사요법%방사요법,대분할%방사요법,조강%부반응
Prostate neoplasms/radiotherapy%Radiotherapy,hypofractionated%Radiotherapy,intensity-modulated%Side effects
目的 分析前列腺癌大分割照射患者的早期和晚期副反应,初步探讨副反应的影响因素.方法 2006-2008年间37例前列腺痛患者接受大分割调强放疗(IMRT).13例临床靶体积(CTV)包括前列腺±精囊或术后瘤床,24例包括前列腺、精囊(或术后瘤床)和盆腔淋巴引流区.分次照射剂量为2.3～2.8 Gy(2.7 Gy占26例).95%PTV处方剂量前列腺精囊为62.5～75.0 Gy,盆腔为50.0 Gy.结果 全组中位随访时间为14个月.早期胃肠反应发生率0级38%,1级2,4%,2级35%,3级3%;直肠V50>27%与V55>20%的≥1级早期直肠反应发生率不同(P<0.05).早期泌尿系统反应发生率0级30%,1级68%,2级0和3级3%;膀胱V60<10%与V60>10%的≥1级泌尿系统反应发生率也不同(X2=6.02,P=0.038).晚期直肠反应发生率0级70%,1级24%,2级5%,无3、4级反应;直肠V65<10%与V65>10%的≥1级晚期胃肠反应发生率不同(X2=5.58,P=0.020).晚期泌尿系统反应发生率0级38%,1级49%,2级11%,3级3%,无4级反应;膀胱平均剂量>40Gy、V40>32%与V50>29%的≥2级晚期泌尿系统反应发生率均不同.结论 前列腺癌大分割IMRT初步研究结果 显示急件和晚期副反应均在可接受范围内.
目的 分析前列腺癌大分割照射患者的早期和晚期副反應,初步探討副反應的影響因素.方法 2006-2008年間37例前列腺痛患者接受大分割調彊放療(IMRT).13例臨床靶體積(CTV)包括前列腺±精囊或術後瘤床,24例包括前列腺、精囊(或術後瘤床)和盆腔淋巴引流區.分次照射劑量為2.3～2.8 Gy(2.7 Gy佔26例).95%PTV處方劑量前列腺精囊為62.5～75.0 Gy,盆腔為50.0 Gy.結果 全組中位隨訪時間為14箇月.早期胃腸反應髮生率0級38%,1級2,4%,2級35%,3級3%;直腸V50>27%與V55>20%的≥1級早期直腸反應髮生率不同(P<0.05).早期泌尿繫統反應髮生率0級30%,1級68%,2級0和3級3%;膀胱V60<10%與V60>10%的≥1級泌尿繫統反應髮生率也不同(X2=6.02,P=0.038).晚期直腸反應髮生率0級70%,1級24%,2級5%,無3、4級反應;直腸V65<10%與V65>10%的≥1級晚期胃腸反應髮生率不同(X2=5.58,P=0.020).晚期泌尿繫統反應髮生率0級38%,1級49%,2級11%,3級3%,無4級反應;膀胱平均劑量>40Gy、V40>32%與V50>29%的≥2級晚期泌尿繫統反應髮生率均不同.結論 前列腺癌大分割IMRT初步研究結果 顯示急件和晚期副反應均在可接受範圍內.
목적 분석전렬선암대분할조사환자적조기화만기부반응,초보탐토부반응적영향인소.방법 2006-2008년간37례전렬선통환자접수대분할조강방료(IMRT).13례림상파체적(CTV)포괄전렬선±정낭혹술후류상,24례포괄전렬선、정낭(혹술후류상)화분강림파인류구.분차조사제량위2.3～2.8 Gy(2.7 Gy점26례).95%PTV처방제량전렬선정낭위62.5～75.0 Gy,분강위50.0 Gy.결과 전조중위수방시간위14개월.조기위장반응발생솔0급38%,1급2,4%,2급35%,3급3%;직장V50>27%여V55>20%적≥1급조기직장반응발생솔불동(P<0.05).조기비뇨계통반응발생솔0급30%,1급68%,2급0화3급3%;방광V60<10%여V60>10%적≥1급비뇨계통반응발생솔야불동(X2=6.02,P=0.038).만기직장반응발생솔0급70%,1급24%,2급5%,무3、4급반응;직장V65<10%여V65>10%적≥1급만기위장반응발생솔불동(X2=5.58,P=0.020).만기비뇨계통반응발생솔0급38%,1급49%,2급11%,3급3%,무4급반응;방광평균제량>40Gy、V40>32%여V50>29%적≥2급만기비뇨계통반응발생솔균불동.결론 전렬선암대분할IMRT초보연구결과 현시급건화만기부반응균재가접수범위내.
Objective To analyze the acute and late toxicities in patients with prostate cancer trea-ted with hypofractionated intensity-modulated radiotherapy (IMRT). Methods Between June 2006 and June 2008, 37 patients with prostate cancer were treated with hypofractionated IMRT. The clinical target vol-ume (CTV) was the prostate, seminal vesicles and pelvic lymph nodes in 24 patients, the prostate and semi-hal vesicles in 12, and only the tumor bed in 1. The dose per fraction was 2.3 - 2.8 Gy, with 2.7 Gy in 26 patients. The minimal dose was 62.5-75.0 Gy to the prostate and seminal vesicles, and 50 Gy to the pelvic lymph nodes. Results The median follow-up was 14 months. None of the patients experienced grade 4 a-cute gastro-intestinal (GI) toxicity. Grade 1, 2 and 3 acute GI toxicity occurred in 24.3%, 35.1% and 2.7% of the patients, respectively. The rectal V50>27% and V55>20% were highly significantly associat-ed with grade ≥1 acute GI toxicity. Grade 1,2 and 3 acute genitourinary (GU) toxicity occurred in 68%, 0% and 3% of the patients, respectively. The bladder V50> 10% was significantly associated with grade ≥1 acute GU toxicity. The incidence of late GI toxicity was low. No grade ≥3 late GI toxicity was observed. The incidence of late grade 1 and 2 GI toxicity was 24% and 5%, respectively. The rectal V65> 10% was highly significantly associated with grade ≥1 late GI toxicity. No late grade 4 GU toxicity was observed. The incidence of grade 1, 2 and 3 late GU toxicity was 49%, 11% and 3%, respectively. Grade ≥2 late GU toxicity was correlated with V40, V50 and mean dose of the bladder. Conclusions Acute and late toxicity of hypofractionated IMRT is acceptable in patients with prostate cancer.
