前列腺癌术后中等分割放射治疗I期临床研究

Phase I study of moderately hypo-fractionated intensity modulated radiotherapy after prostatectomy

目的 评价前列腺癌术后中等分割照射的急性不良反应。方法 选取2017年2月至8月，本院20例前列腺癌术后患者入组。中等分割处方剂量为盆腔45 Gy/25次，1.8 Gy/次；前列腺床62.75 Gy/25次，2.51 Gy/次。不良反应的评价采用北美放射肿瘤协作组（RTOG）急性不良反应评价标准和常见不良事件评价标准（CTCAE）4.0。结果 中位随访时间7.5个月。1例（5%）患者出现了2级急性胃肠反应；2例（10%）患者出现了2级急性泌尿反应。2例（10%）患者放射治疗期间出现了2级尿失禁，放疗后1个月恢复至0级或1级。结论 与既往常规分割照射文献相比，前列腺癌术后中等分割照射模式（2.51 Gy/次×25次）没有明显增加患者急性胃肠、泌尿系统不良反应。近期随访结果显示，没有增加患者尿失禁风险。

Objective To assess the acute toxicity of a hypo-fractionated regimen of intensity-modulated radiotherapy to the prostatic bed after prostatectomy. Methods From February to August 2017, twenty cases with prostate adenocarcinoma after prostatectomy were recruited. The prescribed dose to the whole pelvis and the prostatic bed was 45 Gy delivered in 1.8 Gy per fraction and 62.75 Gy delivered in 2.51 Gy per fraction, respectively. Acute toxicity was recorded and graded according to Radiation Therapy Oncology Group （RTOG） criteria and Common Terminology Criteria for Adverse Events （CTCAE） 4.0. Results The median follow-up was 7.5 months. Grade 2 acute genitourinary and gastrointestinal toxicity was observed respectively in two cases （10%） and one （5%）, respectively. Two cases（10%） complained of grade 2 urinary incontinence during radiation therapy, but recovered to grade 0 or grade 1 after the first month of follow-up. Conclusions After prostatectomy, moderately hypo-fractionated radiotherapy （2.51 Gy×25） compared with conventional fractionated radiotherapy previously reported did not increase the risk of acute toxicity. The incidence of urinary incontinence did not increase during short-term of follow-up.