前列腺癌大分割与常规分割图像引导放疗中注入水凝胶后的直肠毒性比较研究

Study on Comparison of Rectal Toxicity After Hydrogel Injection in Hypofractionated and Conventional Fractionation Image Guided Radiotherapy for Prostate Cancer

目的比较前列腺癌(prostate cancer,PCa)大分割和常规分割放疗中注入水凝胶后的直肠毒性。方法筛选2022-10/2023-10月作者医院放疗科PCa患者130例,收集其临床资料用于前瞻性研究。采用简单随机分配法将患者分为注入水凝胶的大分割放疗组(n=50)和常规分割放疗组(n=80)。采用美国肿瘤放射治疗协作组织(radiation therapy oncology group,RTOG)急性不良反应评价标准和常见不良事件评价标准(common adverse event evaluation criteria,CTCAE)5.0版评价和比较两组PCa患者急性和晚期放射性直肠炎(radiation proctitis,RP)发生率。结果两组PCa患者基线资料比较差异均无统计学意义(P>0.05)。大分割放疗组、常规分割放疗组PCa患者发生急性Ⅰ级RP的发生率为12.00%和17.50%,发生晚期Ⅰ级RP的发生率为4.00%和5.00%,均无患者发生急性或晚期Ⅰ级以上RP,两组PCa患者急性和晚期Ⅰ级RP发生率比较差异均无统计学意义(P>0.05)。结论两种放射疗法中注入水凝胶后直肠毒性较为接近,水凝胶的应用具有一定的普适性。

Objective To compare the rectal toxicity after hydrogel injection in hypofractionated and conventional fractionation radiotherapy for prostate cancer(PCa).Methods A total of 130 patients with PCa in the department of radiotherapy in author's hospital from October 2022 to October 2023 were screened,and their clinical data were collect-ed for prospective study.The patients were divided into the hypofractionated radiotherapy group injected with hydrogel(n=50)and the conventional fractionation radiotherapy group(n=80)by simple random assignment method.The in-cidence of acute and advanced radiation proctitis(RP)of PCa patients between the two groups were evaluated and com-pared by America cancer radiation therapy oncology group(RTOG)evaluation criteria for the acute adverse reaction and common adverse event evaluation criteria(CTCAE)version 5.0.Results There was no significant difference in base-line data of PCa patients between the two groups.The incidence of acute gradeⅠRP in the hypofractionated radiothera-py group and conventional fractionation radiotherapy group was 12.00%and 17.50%,and the incidence of advanced gradeⅠRP was 4.00%and 5.00%,there was no acute or advanced RP above gradeⅠin both groups,and there was no significant difference in the incidence of acute and advanced gradeⅠRP of PCa patients between the two groups(P>0.05).Conclusion The rectal toxicity after hydrogel injection in two radiotherapy methods is similar,and the applica-tion of hydrogel has certain universality.