[an error occurred while processing this directive]|[an error occurred while processing this directive]
寡转移去势抵抗前列腺癌原发灶与转移灶放疗不良反应分析
李洪振, 高献书, 亓昕, 秦尚彬, 纪辰, 张敏, 李晓颖, 王庆国, 李晓梅
100034 北京大学第一医院放疗科
Analysis of adverse events after radiotherapy for primary and metastatic prostate carcinoma in patients with oligometastasized castration resistant prostate carcinoma
Li Hongzhen, Gao Xianshu, Qi Xin, Qin Shangbin, Ji Chen, Zhang Min, Li Xiaoying, Wang Qingguo, Li Xiaomei
Department of Radiation Oncology,First Hospital,Peking University,Beijing 100034,China
Abstract：Objective To analyze the adverse events in patients diagnosed with oligometastasized castration resistant prostate carcinoma (CRPC) receiving radiotherapy for the primary and metastatic prostate carcinomas. Methods Twenty patients with oligometastasized CRPC admitted to our hospital between 2011 and 2015 were treated with image-guided volumetric modulated arc therapy (VMAT). The dose for prostate+ seminal vesicle was 76 Gy/38 f,46 Gy/23 f for the pelvic lymph node and the median dose for the metastatic lesions was 60 Gy (52-66)/23 f. Relevant clinical data and adverse events were analyzed. Results All patients completed the radiotherapy. Only 1 patient showed grade Ⅲ urinary obstruction and received catheterization. In terms of acute adverse events of ≥ grade Ⅱ, urinary tract was observed in 4 cases (20%), rectum in 2(10%) and blood system in 2(10%). The rectal V50 was correlated with acute adverse events of ≥ grade Ⅱ. The median follow-up time was 24.2 months. No patient suffered from late adverse events of ≥ grade Ⅱ. All cases showed a decline in the level of prostate specific antigen (PSA) after radiotherapy. The median PSA reduction rate was 99%. Among them, 16 cases (80%) had a PSA reduction rate of over 90%. Conclusions It is safe and efficacious to perform radical dosage radiotherapy for primary and metastatic prostate carcinomas in patients with oligometastasized CRPC.
Li Hongzhen,Gao Xianshu,Qi Xin et al. Analysis of adverse events after radiotherapy for primary and metastatic prostate carcinoma in patients with oligometastasized castration resistant prostate carcinoma[J]. Chinese Journal of Radiation Oncology, 2018, 27(2): 181-184.
[1] Hanna N,Sun MX,Meyer CP,et al. Survival analyses of patients with metastatic renal cancer treated with targeted therapy with or without cytoreductive nephrectomy:a national cancer data base study[J].J Clin Oncol,2016,34(27):3267-3275.DOI:10.1200/JCO.2016.66.7931. [2] Cowan RA,Eriksson AGZ,Jaber SM,et al. A comparative analysis of prediction models for complete gross resection in secondary cytoreductive surgery for ovarian cancer[J].Gynecol Oncol,2017,145(2):230-235.DOI:10.1016/j.ygyno.2017.02.010. [3] Cornford P,Bellmunt J,Bolla M,et al. EAU-ESTRO-SIOG guidelines on prostate cancer. Part Ⅱ:treatment of relapsing,metastatic,and castration-resistant prostate cancer[J].Eur Urol,2017,71(4):630-642.DOI:10.1016/j.eururo.2016.08.002. [4] Rusthoven CG,Jones BL,Flaig TW,et al. Improved survival with prostate radiation in addition to androgen deprivation therapy for men with newly diagnosed metastatic prostate cancer[J].J Clin Oncol,2016,34(24):2835-2842.DOI:10.1200/JCO.2016.67.4788. [5] 高献书,亓昕.前列腺癌根治性放疗靶区勾画共识与争议[J].中华放射肿瘤学杂志,2014,23(4):279-281.DOI:10.3760/cma.j.issn.1004-4221.2014.04.001.Gao XS,Qi X. Consensus and controversy in the target area of radical radiotherapy for prostate cancer[J].Chin J Radiat Oncol,2014,23(4):279-281.DOI:10.3760/cma.j.issn.1004-4221.2014.04.001. [6] James ND,Sydes MR,Clarke NW,et al. Addition of docetaxel,zoledronic acid,or both to first-line long-term hormone therapy in prostate cancer (stampede):survival results from an adaptive,multiarm,multistage,platform randomised controlled trial[J].Lancet,2016,387(10024):1163-1177.DOI:10.1016/S0140-6736(15)01037-5. [7] Badrising S,van der Noort V,van Oort IM,et al. Clinical activity and tolerability of enzalutamide (mdv3100) in patients with metastatic,castration-resistant prostate cancer who progress after docetaxel and abiraterone treatment[J].Cancer,2014,120(7):968-975.DOI:10.1002/cncr.28518. [8] Ryan CJ,Smith MR,Fizazi K,et al. Abiraterone acetate plus prednisone versus placebo plus prednisone in chemotherapy-naive men with metastatic castration-resistant prostate cancer (cou-aa-302):final overall survival analysis of a randomised,double-blind,placebo-controlled phase 3 study[J].Lancet Oncol,2015,16(2):152-160.DOI:10.1016/S1470-2045(14)71205-7. [9] Tosoian JJ,Gorin MA,Ross AE,et al. Oligometastatic prostate cancer:Definitions,clinical outcomes,and treatment considerations[J].Nat Rev Urol,2017,14(1):15-25.DOI:10.1038/nrurol.2016.175. [10] Akimoto T,Kitamoto Y,Saito JI,et al. External beam radiotherapy for clinically node-negative,localized hormone-refractory prostate cancer:impact of pretreatment PSA value on radiotherapeutic outcomes[J].In J Radiat Oncol Biol Phys,2004,59(2):372-379.DOI:10.1016/j.ijrobp.2003.10.033. [11] Hakariya T,Obata S,Igawa T,et al. Feasibility of simultaneous integrated boost IMRT (SIB-IMRT) for castration-resistant prostate cancer[J].Anticancer Res,2014,34(8):4261-4265.
2018, Vol. 27 
