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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Clinical experience with intensity modulated radiation therapy (IMRT) in prostate cancer.
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Clinical experience with intensity modulated radiation therapy (IMRT) in prostate cancer.

机译：调强放射疗法（IMRT）在前列腺癌中的临床经验。

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摘要

PURPOSE: To compare acute and late toxicities of high-dose radiation for prostate cancer delivered by either conventional three-dimensional conformal radiation therapy (3D-CRT) or intensity modulated radiation therapy (IMRT). MATERIALS AND METHODS: Between September 1992 and February 1998, 61 patients with clinical stage T1c- T3 prostate cancer were treated with 3D-CRT and 171 with IMRT to a prescribed dose of 81 Gy. To quantitatively evaluate the differences between conventional 3D-CRT and IMRT, 20 randomly selected patients were planned concomitantly by both techniques and the resulting treatment plans were compared. Acute and late radiation-induced morbidity was evaluated in all patients and graded according to the Radiation Therapy Oncology Group toxicity scale. RESULTS: Compared with conventional 3D-CRT, IMRT improved the coverage of the clinical target volume (CTV) by the prescription dose and reduced the volumes of the rectal and bladder walls carried to high dose levels (P<0.01), indicating improved conformality with IMRT. Acute and late urinary toxicities were not significantly different for the two methods. However, the combined rates of acute grade 1 and 2 rectal toxicities and the risk of late grade 2 rectal bleeding were significantly lower in the IMRT patients. The 2-year actuarial risk of grade 2 bleeding was 2% for IMRT and 10% for conventional 3D-CRT (P<0.001). CONCLUSIONS: The data demonstrate the feasibility and safety of high-dose IMRT for patients with localized prostate cancer and provide a proof-of-principle that this method improves dose conformality relative to tumor coverage and exposure to normal tissues.
机译：目的：比较大剂量放射治疗对常规三维共形放射治疗（3D-CRT）或强度调制放射治疗（IMRT）所产生的前列腺癌的急性和晚期毒性。材料与方法：在1992年9月至1998年2月之间，采用3D-CRT治疗61例临床分期为T1c-T3前列腺癌的患者，采用IMRT治疗171例患者，处方剂量为81 Gy。为了定量评估传统3D-CRT和IMRT之间的差异，同时通过两种技术计划了20位随机选择的患者，并对产生的治疗计划进行了比较。对所有患者的急性和晚期放射诱发的发病率进行了评估，并根据放射治疗肿瘤学组毒性量表进行了分级。结果：与传统的3D-CRT相比，IMRT通过处方剂量改善了临床目标体积（CTV）的覆盖率，并将直肠和膀胱壁的体积减小至高剂量水平（P <0.01），表明与IMRT。两种方法的急性和晚期尿毒症无明显差异。但是，IMRT患者的急性1级和2级直肠毒性综合发生率和晚期2级直肠出血的风险显着降低。 IMRT的2年2年期出血的2年精算风险和常规3D-CRT的2年精算风险为10％（P <0.001）。结论：数据证明了大剂量IMRT治疗局限性前列腺癌的可行性和安全性，并提供了一种原理证明，该方法相对于肿瘤覆盖和暴露于正常组织可以提高剂量的适应性。

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