调强适形放射治疗晚期前列腺癌的临床观察

目的：观察调强适形放射治疗（ＩＭＲＴ）对晚期前列腺癌患者的近期疗效及毒副作用。方法：对１５例病理明确的Ｔ４期患者行ＩＭＲＴ，２.２Ｇｙ／次，每日１次，每周照射５天，ＤＴ：８０Ｇｙ／３６ｆ，５３天完成。观察近期疗效包括排尿改善、ＰＳＡ变化、肿块缩小以及毒副作用。近期疗效采用ＷＨＯ实体瘤标准评价，毒副作用采用ＲＴＯＧ急性及晚期放射损伤分级标准。结果：１１例有排尿困难的患者放疗结束时症状基本缓解；除２例ＰＳＡ＞１００ｎｇ／ｍｌ外，９例放疗后６个月ＰＳＡ值明显下降。放疗后１、３、６个月复查有效率（按前列腺局部计算）分别为６６.７％（１０／１５）、６６.７％（１０／１５）和８０.０％（１２／１５）。急性胃肠道放射反应为２６.７％（４／１５），２级６.７％（１／１５），未出现３级，未发现有晚期胃肠道放射反应。急性泌尿系统放射反应为４０.０％（６／１５），２级１３.３％（２／１５）；晚期泌尿系统放射反应为２０.０％（３／１５），２级１３.３％（２／１５，前列腺电气化治疗患者），未出现３级毒副反应。结论：ＩＭＲＴ治疗晚期前列腺癌近期疗效满意，毒副作用较轻，患者生活质量提高。

Clinical observation of intensity-modulated radiation therapy in advanced prostate cancer

Objective：To evaluate the short time efficacy,acute and late toxicity in advanced prostate cancer patients treated by intensity-modulated radiation therapy（IMRT）.Methods：Fifteen men were treated by 80Gy IMRT,and 2.2Gy per fraction and 5 fractions every week.The short time efficacy and toxicity were observed according to WHO and RTOG score.Results：The remission rates after 1,3,6 months were 66.7%（10/15）,66.7%（10/15） and 80.0%（12/15）.Acute and maximal late grade 2 gastrointestinal toxicity was 26.7% and 6.7%,late grade 2 gastrointestinal toxicity dropped to 0 at the end of follow-up.No acute or late grade 3 gastrointestinal toxicity was observed.Acute and maximal late grade 2 genitourinary toxicity was 40.0% and 13.3% respectively.And late grade 2 genitourinary toxicity was 13.3% at the end of follow-up.No acute and maximal late grade 3 genitourinary toxicity was observed too.Conclusion：The short time efficacy was satisfied.Gastrointestinal toxicity rates after IMRT and organ tracking were excellent.