CAJ | 학술논문

目的：探讨前列腺癌术后切缘阳性患者采用直线加速器调强放疗同步内分泌药物治疗的临床疗效及晚期损伤。方法将22例 II、III 期前列腺癌术后切缘阳性的患者，采用6MVX 线调强放射治疗，临床靶区包括前列腺瘤床及前列腺尖部残存病灶，先 DT：57.5 Gy/25 f/5 w，2.3 Gy/ f，1 f/ d，5 f/ w，后缩野改计划，前列腺残存病灶至 DT：69 Gy/30 f/6 w。放疗第一日起应用内分泌药物治疗，比卡鲁胺50 mg/次，1次/日，口服，连用2~3年；戈舍瑞林3.6 mg/次，28天1次，皮下注射，连用6~12月。结果3、5年生存率分别为90.9%和81.8%；3、5年无疾病进展生存分别为86.3%和77.2%；晚期放射性直肠炎及尿道炎的发生率分别为22.7%和18.2%。结论对于 II、III 期前列腺癌术后切缘阳性的患者，调强放疗同步内分泌药物治疗，安全、可靠、有效，晚期放射性损伤可耐受。
목적：탐토전렬선암술후절연양성환자채용직선가속기조강방료동보내분비약물치료적림상료효급만기손상。방법장22례 II、III 기전렬선암술후절연양성적환자，채용6MVX 선조강방사치료，림상파구포괄전렬선류상급전렬선첨부잔존병조，선 DT：57.5 Gy/25 f/5 w，2.3 Gy/ f，1 f/ d，5 f/ w，후축야개계화，전렬선잔존병조지 DT：69 Gy/30 f/6 w。방료제일일기응용내분비약물치료，비잡로알50 mg/차，1차/일，구복，련용2~3년；과사서림3.6 mg/차，28천1차，피하주사，련용6~12월。결과3、5년생존솔분별위90.9%화81.8%；3、5년무질병진전생존분별위86.3%화77.2%；만기방사성직장염급뇨도염적발생솔분별위22.7%화18.2%。결론대우 II、III 기전렬선암술후절연양성적환자，조강방료동보내분비약물치료，안전、가고、유효，만기방사성손상가내수。
Objective To investigate the clinical effects and advanced damages of intensity - modulated radiotherapy(IMRT)combined with endocrine therapy for the positive surgical margin of the prostate cancer after the radical prostatectomy. Methods Twenty - two patients with stage II or III prostate cancer and the positive surgical margin of the prostate cancer after radical prostatectomy were treated by IMRT combined with endocrine therapy. The regimen was taken as follows:the clinical target volume included the tumor bed and the residual lesions apex of the pros-tate,2. 3Gy per fraction,once a day,five times a week,and DT was 57. 5 Gy and 69Gy respectively. The endocrine scheme was given bicalu-tamide(50 mg,oral,once a day,continous 2 ~ 3 years)and goserelin(3. 6 mg,subcutaneous injection,once a month,continous 6 ~ 12 months)since the first day of radiotherapy. Results The three - year and five - year survival rates were 90. 9% and 81. 8% respectively. The three - year and five - year progression - free survival rates were 86. 3% and 77. 2% respectively. The advanced radiation proctitis and urethritis were 22. 7% and 18. 2% % respectively. Conclusion The IMRT combined with endocrine therapy for the positive surgical margin of the stage II and III prostate cancer after the radical prostatectomy is safe,reliable and effective. The advanced damage is tolerable.