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前列腺癌局部调强放疗是否同步盆腔照射不良反应比较
刘跃平,李晔雄,王维虎,金晶,房辉,王淑莲,宋永文,任骅,刘新帆,余子豪戴建荣,
100021 北京协和医学院中国医学科学院肿瘤医院肿瘤研究所放疗科
Toxicities of intensity-modulated radiotherapy with or without pelvic nodal irradiation in patients with localized prostate cancer:a comparative study
LIU Yue-ping, LI Ye-xiong, WANG Wei-hu, JIN Jing, FANG Hui, WANG Shu-lian, SONG Yong-wen, REN Hua, LIU Xin-fan, YU Zi-hao,. DAI Jian-rong.
Department of Radiation Oncology．Cancer Hospital (Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021,China
Corresponding author:LI Ye-xiong
Objective To analyze the acute and late intestinal and genitourinary toxicities of intensity-modulated radiotherapy (IMRT) with or without pelvic nodal irradiation in patients with localized prostate cancer. Methods Eighty-three patients with pelvic-confined prostate cancer, who received radical IMRT between February 2009 and March 2012, were included in the study. Of them, 38 low-and medium-risk patients received hypofractionated IMRT (67.5 Gy) to the prostate (and seminal vesicles), and 45 high-risk patients or patients who had an assessed risk of pelvic lymph node metastasis above 15% received hypofractionated IMRT (67.5 Gy) to the prostate and seminal vesicles as well as prophylactic irradiation (50 Gy) to the pelvic lymph nodes. The gastrointestinal and genitourinary toxicities were evaluated during and after radiotherapy. Acute toxicities were graded according to common terminology criteria for adverse events, version 3.0, while late toxicities were graded according to the toxicity criteria of the radiation therapy oncology group. Results Of the patients receiving pelvic nodal irradiation, 27% and 0% experienced grade 2 and 3 acute gastrointestinal toxicities, versus 5% and 3% of those not receiving pelvic nodal irradiation (P=0.025);11% and 9% of the patients receiving pelvic nodal irradiation experienced grade 2 and 3 late gastrointestinal toxicities, versus 29% and 3% of those not receiving pelvic nodal irradiation (P=0.170). Of the patients receiving pelvic nodal irradiation, 13% and 0% experienced grade 2 and 3 acute genitourinary toxicities, versus 16% and 3% of those not receiving pelvic nodal irradiation (P=0.368);9% and 2% of the patients receiving pelvic nodal irradiation experienced grade 2 and 3 late genitourinary toxicities, versus 24% and 3% of those not receiving pelvic nodal irradiation (P=0.066). Conclusions Pelvic nodal irradiation during IMRT increases the incidence of acute gastrointestinal toxicity in patients with prostate cancer, but it does not increase the incidence of late gastrointestinal and genitourinary toxicities.
. Toxicities of intensity-modulated radiotherapy with or without pelvic nodal irradiation in patients with localized prostate cancer:a comparative study[J]. Chinese Journal of Radiation Oncology, 2013, 22(3): 190-192.
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2013, Vol. 22 
