CAJ | 학술논문

目的分析前列腺癌调强放疗中盆腔照射与否的肠道和泌尿道急慢性不良反应差别.方法 2009-2012年局限于盆腔接受根治性调强放疗的前列腺癌83例,其中38例中低危患者前列腺±精囊腺放疗67.5 Gy,45例高危或盆腔淋巴结转移风险预测＞15％者前列腺和精囊腺放疗67.5Gy同步盆腔照射50 Gy.急性不良反应依据不良反应常见术语标准3.0版进行评价,慢性不良反应依据美国肿瘤放疗协会标准评测.结果盆腔放疗与无放疗的肠道2、3级急性不良反应分别为27％、0％与5％、3％ (P =0.025),晚期不良反应分别为11％、9％与29％、3％ (P =0.170)；泌尿道2、3级急性不良反应分别为13％、0％与16％、3％(P=0.368),慢性不良反应分别为9％、2％与24％、3％(P=0.066).结论前列腺癌放疗中盆腔放疗增加了肠道急性不良反应,但未增加肠道和泌尿道晚期损伤.
목적 분석전렬선암조강방료중분강조사여부적장도화비뇨도급만성불량반응차별.방법 2009-2012년국한우분강접수근치성조강방료적전렬선암83례,기중38례중저위환자전렬선±정낭선방료67.5 Gy,45례고위혹분강림파결전이풍험예측＞15％자전렬선화정낭선방료67.5Gy동보분강조사50 Gy.급성불량반응의거불량반응상견술어표준3.0판진행평개,만성불량반응의거미국종류방료협회표준평측.결과 분강방료여무방료적장도2、3급급성불량반응분별위27％、0％여5％、3％ (P =0.025),만기불량반응분별위11％、9％여29％、3％ (P =0.170)；비뇨도2、3급급성불량반응분별위13％、0％여16％、3％(P=0.368),만성불량반응분별위9％、2％여24％、3％(P=0.066).결론 전렬선암방료중분강방료증가료장도급성불량반응,단미증가장도화비뇨도만기손상.
Objective To analyze the acute and late intestinal and genitourinary toxicities of intensity-modulated radiotherapy (IMRT) with or without pelvic nodal irradiation in patients with localized prostate cancer.Methods Eighty-three patients with pelvic-confined prostate cancer,who received radical IMRT between February 2009 and March 2012,were included in the study.Of them,38 low-and mediumrisk patients received hypofractionated IMRT (67.5 Gy) to the prostate (and seminal vesicles),and 45 high-risk patients or patients who had an assessed risk of pelvic lymph node metastasis above 15％ received hypofractionated IMRT (67.5 Gy) to the prostate and seminal vesicles as well as prophylactic irradiation (50 Gy) to the pelvic lymph nodes.The gastrointestinal and genitourinary toxieities were evaluated during and after radiotherapy.Acute toxicities were graded according to common terminology criteria for adverse events,version 3.0,while late toxicities were graded according to the toxicity criteria of the radiation therapy oncology group.Results Of the patients receiving pelvic nodal irradiation,27％ and 0％ experienced grade 2 and 3 acute gastrointestinal toxicities,versus 5％ and 3％ of those not receiving pelvic nodal irradiation (P =0.025) ;11％ and 9％ of the patients receiving pelvic nodal irradiation experienced grade 2 and 3 late gastrointestinal toxicities,versus 29％ and 3％ of those not receiving pelvic nodal irradiation (P =0.170).Of the patients receiving pelvic nodal irradiation,13％ and 0％ experienced grade 2 and 3 acute genitourinary toxicities,versus 16％ and 3％ of those not receiving pelvic nodal irradiation (P =0.368) ;9％ and 2％ of the patients receiving pelvic nodal irradiation experienced grade 2 and 3 late genitourinary toxicities,versus 24％ and 3％ of those not receiving pelvic nodal irradiation (P =0.066).Conclusions Pelvic nodal irradiation during IMRT increases the incidence of acute gastrointestinal toxicity in patients with prostate cancer,but it does not increase the incidence of late gastrointestinal and genitourinary toxicities.