摘要
目的 分析前列腺癌适形调强放射治疗的临床疗效、副反应,分析前列腺癌特异性抗原（PSA）的变化水平和意义.方法 62例前列腺痛患者,60例采用调强放疗,2例采用三维适形放疗.56例放疗前接受内分泌治疗.前列腺＋精囊95%计划靶体积的中位处方剂量为78 Gy,盆腔的为48 Gy.放疗前、后测量血液中PSA水平,观察PSA最低点值与预后关系.观察正常组织早、晚期副反应.结果 中位随访时间15.4个月.全组3年无远处转移生存率、无生化复发生存率、总生存率和肿瘤特异生存率分别为77%、87%、90%和92%,5年无远处转移生存率、无生化复发生存率和总生存率分别为55%、69%和83%.放疗后PSA最低点≤2 ng/ml与〉2 ng/ml的3年总生存率和无远处转移生存率分别为94%、88%%与56%、11%（χ^2=16.39,P〈0.01;χ^2=28.87,P〈0.01）.1、2级早期泌尿系统副反应发生率分别为32%、0%,1、2级早期直肠副反应发生率分别为19%、3%,1、2级嗍泌尿系统副反应发生率分别为10%、0%,1、2级晚期直肠副反应发生率分别为5%、3%.结论 前列腺癌适形调强放疗疗效好,早、晚期副反应小;放疗后PSA监测利于判断肿瘤预后.
Objective To evaluate the prognosis and side-effects of three-dimensional conformal radiotherapy （ 3 DCRT ） and intensity modulated radiotherapy （ IMRT ） for prostate carcinoma. Methods From 2001 to 2009, 62 patients with prostate carcinoma treated with radiotherapy were included in the retrospective analysis. Among them, 60 patients received IMRT while the other two received 3DCRT. There were 56 patients receiving androgen deprivation therapy before radiotherapy. The median dose was 78 Gy to 95% planning target volume （PTV） of the prostate and seminal vesicles, and the median dose to 95% PTV of the pelvic lymph nodes was 48 Gy. Results The median follow-up was 15.4 months. The 3-and 5-year overall survival （OS） rates were 92% and 83% , with the corresponding biochemical disease-free survival rates of 87% and 69%, and the distant metastasis-free survival （DMFS） rate of 77% and 55%, respectively. Patients with a PSA nadir ≤2 ng/ml had a 3-year OS of 94% and DMFS of 88% , compared with 56% and 11% （χ^2 ： 16.39,P 〈0. 01 for OS;χ^2 = 28.87,P〈0.01 for DMFS） for those with a PSA nadir 〉 2 ng/ml. The incidence of grade 1 and 2 urinary toxicity was 32% and 0% for acute damage, 10% and 0% for late damage, respectively. The incidence of grade 1 and 2 intestinal toxicity was 19% and 3%. for acute damage, 5% and 3% for late damage, respectively. Conclusions Radiation therapy for patients with prostate carcinoma shows satisfactory outcomes with a good toleration. Monitor of PSA after radiotherapy has benefit for prognosis evaluation.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2010年第3期231-235,共5页
Chinese Journal of Radiation Oncology
关键词
前列腺肿瘤/放射疗法
放射疗法
调强
预后
前列腺特异抗原
Prostate neoplasm/radiotherapy
Radiotherapy, three-dimensional conformal
Prognosis
Prostate specific antigen
