| 1 | Long-term outcome of a moderately hypofractionated, intensity-modulated radiotherapy approach using an endorectal balloon for patients with localized prostate cancer显示文摘Background:Technical advances in radiotherapy delivery have simultaneously enabled dose escalation and enhanced bladder and rectal sparing.However,the optimal radiation fractionation regimen for localized prostate cancer is unclear.Laboratory and clinical evidence suggest that hypofractionation may improve the therapeutic ratio of radiotherapy.We report our institutional outcomes using moderately hypofractionated,intensity-modulated radio-therapy(IMRT),and an endorectal balloon,with emphasis on long-term biochemical control and treatment-related adverse events in patients with localized prostate cancer.Methods:Between January 1997 and April 2004,596 patients with cT1-T3 prostate cancer underwent IMRT using a moderate hypofractionation regimen(76.70 Gy at 2.19 Gy/fraction)with an endorectal balloon.Using D’Amico clas-sification,226(37.9%),264(44.3%),and 106(17.8%)patients had low-,intermediate-,or high-risk disease,respectively.The majority of intermediate-and high-risk patients received androgen deprivation therapy.Biochemical relapse-free survival(bRFS)was evaluated using 2005 Phoenix criteria and estimated using the Kaplan-Meier method.Results:The median follow-up was 62 months.Overall 5-and 10-year bRFS rates were 92.7%and 87.7%.For low-,intermediate-,and high-risk patients,the 5-year bRFS rates were 96.9%,93.3%,and 82.0%,respectively;the 10-year bRFS rates were 91.4%,89.3%,and 76.2%,respectively.Prostate-specific antigen,Gleason score,and T stage were significant predictors of bRFS(all P<0.01).The 5-year rates of severe(≥Grade 3)adverse events were very low:1.2%for gastrointestinal events and 1.1%for genitourinary events.Conclusions:Long-term outcomes after moderately hypofractionated IMRT are encouraging.Moderate hypofrac-tionation represents a safe,efficacious,alternative regimen in the treatment of localized prostate cancer. | Bin S.Teh Gary D.Lewis Weiyuan Mai Ramiro Pino Hiromichi Ishiyama Edward Brian Butler | 2018 | Cancer Communications2018，38，1： | 4 |
| 3 | 对局限性前列腺癌患者采用直肠内球囊中度低分割调强放射治疗的长期结局显示文摘背景与目的放射治疗的技术进步使兼顾剂量递增和提升膀胱和直肠保留成为可能。然而,对于局限性前列腺癌的最佳辐射剂量分割方案尚不清楚。实验室和临床证据表明,低分割可提高放疗的治疗率。在此报道我们医院采用中度低分割调强放疗(intensity?modulated radiotherapy,IMRT)和直肠内球囊对局限性前列腺癌患者的治疗结局,重点关注患者的长期生化控制和治疗相关不良事件。方法从1997年1月到2004年4月,596例c T1–T3前列腺癌患者使用带直肠内球囊的中度低分割方案(76.70 Gy,2.19 Gy/次)进行IMRT。根据D'Amico分类低风险、中风险或高风险患者分别226(37.9%)例、264(44.3%)例和106(17.8%)例。大多数中、高风险患者接受雄激素剥夺治疗。使用2005年Phoenix标准评估无生化复发生存(biochemical relapse?freeSurvival,bRFS),并使用Kaplan?Meier法进行估算。结果中位随访时间为62个月。总的5年bRFS和10年bRFS率分别为92.7%和87.7%。低风险、中风险和高风险患者的5年bRFS率分别为96.9%、93.3%和82.0%,10年bRFS率分别为91.4%、89.3%和76.2%。前列腺特异性抗原、Gleason评分和T分期是bRFS的重要预测因子(均P<0.01)。重度(≥3级)不良事件的5年发生率非常低:胃肠道不良事件和泌尿生殖系统不良事件的发生率分别为1.2%和1.1%。结论中度低分割IMRT后的长期结局令人鼓舞。中度低分割是治疗局限性前列腺癌的安全、有效的替代方案。 | Bin S.Teh Gary D.Lewis Weiyuan Mai Ramiro Pino Hiromichi Ishiyama Edward Brian Butler | 2018 | 癌症2018，37，12： | 0 |
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