调强适形放射治疗晚期前列腺癌的临床观察

Clinical observation of intensity-modulated radiation therapy in advanced prostate cancer

目的:观察调强适形放射治疗(IMRT)对晚期前列腺癌患者的近期疗效及毒副作用。方法:对15例病理明确的T4期患者行IMRT,2.2Gy/次,每日1次,每周照射5天,DT:80Gy/36f,53天完成。观察近期疗效包括排尿改善、PSA变化、肿块缩小以及毒副作用。近期疗效采用WHO实体瘤标准评价,毒副作用采用RTOG急性及晚期放射损伤分级标准。结果:11例有排尿困难的患者放疗结束时症状基本缓解;除2例PSA>100ng/ml外,9例放疗后6个月PSA值明显下降。放疗后1、3、6个月复查有效率(按前列腺局部计算)分别为66.7%(10/15)、66.7%(10/15)和80.0%(12/15)。急性胃肠道放射反应为26.7%(4/15),2级6.7%(1/15),未出现3级,未发现有晚期胃肠道放射反应。急性泌尿系统放射反应为40.0%(6/15),2级13.3%(2/15);晚期泌尿系统放射反应为20.0%(3/15),2级13.3%(2/15,前列腺电气化治疗患者),未出现3级毒副反应。结论:IMRT治疗晚期前列腺癌近期疗效满意,毒副作用较轻,患者生活质量提高。

Objective：To evaluate the short time efficacy,acute and late toxicity in advanced prostate cancer patients treated by intensity-modulated radiation therapy（IMRT）.Methods：Fifteen men were treated by 80Gy IMRT,and 2.2Gy per fraction and 5 fractions every week.The short time efficacy and toxicity were observed according to WHO and RTOG score.Results：The remission rates after 1,3,6 months were 66.7%（10/15）,66.7%（10/15） and 80.0%（12/15）.Acute and maximal late grade 2 gastrointestinal toxicity was 26.7% and 6.7%,late grade 2 gastrointestinal toxicity dropped to 0 at the end of follow-up.No acute or late grade 3 gastrointestinal toxicity was observed.Acute and maximal late grade 2 genitourinary toxicity was 40.0% and 13.3% respectively.And late grade 2 genitourinary toxicity was 13.3% at the end of follow-up.No acute and maximal late grade 3 genitourinary toxicity was observed too.Conclusion：The short time efficacy was satisfied.Gastrointestinal toxicity rates after IMRT and organ tracking were excellent.