局部晚期前列腺癌大分割适形放疗初探

目的：初步评价大分割三维适形放疗（hypofractionated 3dimensional conformal radiotherapy, HFCRT ）对局部晚期前列腺癌的治疗作用。方法：回顾18例曾接受HFCRT的局部晚期（Td期）前列腺癌病例资料。9例单纯HFCRT，40—56Gy／10—16次／2．5—4周；另9例先全盆腔照射36—40Gy／18—20次／3．5—4周，再以HFCRT加量16—20Gy／4—5次／2—3周。分析放疗的生物效应剂量、肿瘤局控效果及临床疗效和不良反应。结果：肿瘤平均生物效应剂量约（125±9．8）Gy（a／13值取2．6Gy）。肿瘤局部疗效CR8例，PR10例。主要临床症状体征明显改善；无≥Ⅲ级放射损伤（RGOT和EORTC毒性标准）。结论：HFCRT对局部晚期前列腺癌有很好的治疗作用，高分次剂量可能是重要的有利因素之一。

Preliminary investigation of hypofractionated conformal radiotherapy for locally advanced prostate cancer

Objective：To preliminarily evaluate the efficacy of hypofractionated 3 dimensional conformal radiother- apy （HFCRT） for locally advanced prostate cancer. Methods：This retrospective study includes 18 cases of locally ad- vanced prostate cancer（phase T4 ）. Nine cases received HFCRT alone, with 40 -58Gy/8 - 16F/2.5 -4 weeks, the others received conventional whole pelvic external beams irradiation with 36 - 40Gy/18 - 20}7/3.5 - 4 weeks, fol- lowed by 3DCRT with 16 -24Gy/4 -5F/2 -3 weeks. We evaluated the biological effective dose（ BED ） ,the state of tumors local control and clinical effect and side effect of radiotherapy for prostate cancer. Results ：The average BED at prostate cancer was （ 125 -＋ 9.8 ） Gy（ ct/13 ratio 2.6Gy） ; 8 tumors were complete response and 10 tumors were partial response ; Most morbid symptoms were alleviated and none of patients experienced I〉 degree Ill toxicity （ RGOT ＆ EORTC criteria）. Conclusion：HFCRT revealed a better effect for the locally advanced prostate cancer, maybe high fractionated dose is an important advantage.