【摘要】 目的分析调强适形放疗治疗前列腺癌的临床疗效及副反应。方法回顾性分析13例接受调强适形放射治疗(intensive modulated radiotherapy,IMRT)的前列腺癌患者资料,8例放疗前接受手术去势,5例接受药物去势。7例临床靶区包括前列腺或前列腺加精囊,另6例同步接受盆腔区域淋巴结照射,前列腺临床靶区的剂量为72 Gy(66～76 Gy),盆腔区域淋巴结剂量为50 Gy(46～54 Gy)。结果完全缓解5例,部分缓解4例,稳定4例,1、3年总生存率分别为92.3%和84.6%。全组早期胃肠道副反应1级8例,2级4例,早期泌尿系副反应1级5例,2级3例,未见3级以上的胃肠道及泌尿系副反应。全组晚期胃肠道副反应1级3例,2级1例,晚期泌尿系副反应1级4例,2级2例,未见3级以上的胃肠道及泌尿系副反应。结论调强适形放疗治疗前列腺癌提高了前列腺肿瘤靶区剂量,降低了PSA生化复发率,前列腺周围器官放疗副反应发生率低,患者可获得较好的放疗耐受性与较高的生活质量。更多还原

【Abstract】 Objective To investigate the clinical outcome and side effects of intensity-modulated radiotherapy(IMRT) for the treatment of prostate cancer.Methods The clinical data of 13 cases of prostate carcinoma treated with IMRT were retrospectively analyzed.8 patients underwent surgical castration before radiotherapy and 5 received medical castration.7 patients’ clinical target volume(CTV) encompassed the prostate and seminal vesicles,the other 6 patients received pelvic lymph nodes radiotherapy at the same time.The dose for prostatic area was 72 Gy(66～76Gy) and the dose for pelvic lymph nodes was 50 Gy(46～54 Gy).Results Among the 13 patients,5 patients were completely relieved,4 partially relieved and 4 remained the same.The 1 and 3-year overall survival rate was 92.3% and 84.6% respectively.Grade I and Grade Ⅱ early Gastrointestinal(GI) toxicity were found in 8 and 4 patients respectively.Grade I and Grade Ⅱ early Genitourinary(GU) toxicity were found in 5 and 3 patients.3 patients developed late Grade I GI toxicity and 1 patient late Grade Ⅱ GI toxicity.4 patients had late Grade I GU toxicity and 2 experienced late Grade Ⅱ GU toxicity.Conclusions IMRT can increase the local dosage of radiation and decrease the biochemical recurrence in prostate cancer.The rate of toxicity of the surrounding tissues is low and patients can gain good tolerability and have quality life.更多还原