三维适形加量放疗联合射频热疗治疗局部晚期前列腺癌的临床观察

Three dimensional conformal radiotherapy combined with radiofrequency hyperthermia for prostate neoplasms

目的:观察三维适形放射治疗(3DCRT)配合射频热疗治疗局部晚期前列腺癌的近期疗效及耐受性。方法:23例局部晚期前列腺癌(Ⅲ～Ⅳ期)患者均行全盆腔放射治疗50Gy后进入三维适形放射治疗配合射频热疗。三维适形放射治疗共行24～26Gy。射频热疗使用ZRL-Ⅰ型热疗仪,射频频率为13.56MHz,射频电容式透热疗法,每周2次,共行3周。结果:23例患者全部完成治疗计划。前列腺癌原发病灶完全缓解(CR)占34.8%,部分缓解(PR)占47.8%,无变化和进展(NC+PD)占17.4%。总有效率(CR+PR)82.6%。据RTOG分级急性膀胱炎1～2级17.4%(4/23),急性直肠炎1～2级39.1%(9/23),骨髓抑制发生率1～2级34.3%(7/23),无3级以上不良反应。23例患者中位随访时间为28个月。随访率为100%。结论:三维适形放射治疗配合射频热疗治疗局部晚期前列腺癌的近期疗效好,并发症发生率低。

Objective：To evaluate the acute side effects and efficacy of three dimensional conformal radiotherapy（3DCRT） combined with hyperthermia for prostate neoplasms.Methods：From Sep.2002,to Dec.2006,23 patients with prostate neoplasms were treated with three dimensional conformal radiotherapy（3DCRT） combined with hyperthermia.Results：The overall response rate（CR＋PR） was 78.3% for the primary tumor.Acute radiation rectitis occurred in 39.1%（9/23）of patients（Grade 1,2）.Acute radiation cystitis was observed in 17.4%（4/23） of patients（Grade1,2）.Grade 1-2 bone marrow suppression occurred in 34.3 %（7/23） of patients.The median follow-up duration was 28（12-39） months.Conclusion：Radiofrequency hyperthermia combined with 3DCRT is well tolerated and improved response rate in most patients with prostate neoplasms.