前列腺癌放射治疗进展

Progress of Radiation Therapy for Prostate Cancer

20世纪50年代用外照射的方法广泛治疗前列腺癌 ,尽管放疗技术有某些改进 ,但常规放射治疗的剂量只是65Gy～70Gy。常规外射线治疗最大程度也只能控制局限的前列腺癌。最近研究用三维适形放射治疗 (3_DCRT)和调强放射治疗 (IMRT) ,以及同时使用雄激素抑制剂。几个随机试验的资料认为 ,局部进展 ,具高危不利因素的前列腺癌的局部失败率明显下降。20世纪80年代 ,前列腺癌近距离治疗出现惊人的发展 ,放射源可以准确插植 ,并有剂量优化。2种同位素适用于低剂量持久性粒子植入 ,即 125I和 103Pd。这项技术可以充分满足前列腺癌所需剂量 。

Approaches of external_beam irradiation for prostate cancer became available in the 1950s.Despite some technique improvements, the conventional radiation dose levels is range of 65Gy～70Gy. The maximal ability of conventional external_beam radiation therapy achieves localized prostate cancer control. Dose escalation with three_dimensional conformal radiation therapy (3_DCRT)and intensity_modulated radiation therapy (IMRT) and use of concomitant androgen deprivation are being investigated. Date from several randomized trials have indicated significantly reducing local failures in locally advanced, high risk prostate cancer.In the 1980s,the use of brachytherapy for prostate cancer had a dramatic improvement in the accuracy of source placement and optimization of dosimetry.Two isotopes Iodine125 and Pallaadium103, are suitable for low_dose permanent seed implantation. This technique ensures adequate dose to the gland while minimizing dose to the rectum and urethra.