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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Radiotherapy with rectangular fields is associated with fewer clinical failures than conformal fields in the high-risk prostate cancer subgroup: Results from a randomized trial
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Radiotherapy with rectangular fields is associated with fewer clinical failures than conformal fields in the high-risk prostate cancer subgroup: Results from a randomized trial

机译：与高风险前列腺癌亚组中的保形场相比，矩形场放疗与更少的临床失败相关：一项随机试验的结果

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Objective High-risk prostate cancer patients are at risk for subclinical disease and micro-metastasis at the time of treatment. Nowadays, tight margins reduce dose to periprostatic areas compared to earlier techniques. We investigated whether rectangular fields were associated with fewer failures compared to conformal fields (with lower extraprostatic dose). Methods We selected 164 high-risk patients from the trial population of 266 T1-T4N0M0 patients, randomized between rectangular (n = 79) and conformal fields (n = 85). Prescribed dose was 66 Gy to the prostate and seminal vesicles plus 15 mm margin. We compared clinical failure rates (in- and excluding local failures), between both arms. Dose differences around the prostate were calculated based on an inter-patient mapping method. Results Median follow-up was 34 months. There were 9 clinical failures in the rectangular arm versus 24 in the conformal arm (p = 0.012). Number of failures outside the prostate was 7 and 19, respectively (p = 0.025). We observed average dose differences of 5-35 Gy between the arms in the regions around the prostate. Conclusions We found a significantly lower risk of early tumor progression for patients treated with rectangular fields. Treatment failure can probably in part be prevented by irradiation of areas suspected of subclinical disease in high-risk prostate cancer.
机译：目的高危前列腺癌患者在治疗时有发生亚临床疾病和微转移的风险。如今，与早期技术相比，狭窄的边缘减少了前列腺周围区域的剂量。我们研究了与保形场（具有较低的前列腺外剂量）相比，矩形场是否与更少的失败相关。方法我们从266名T1-T4N0M0患者的试验人群中选择了164位高危患者，随机分为矩形（n = 79）和保形视野（n = 85）。前列腺和精囊的处方剂量为66 Gy，外缘为15 mm。我们比较了两组之间的临床失败率（包括局部失败在内）。前列腺周围的剂量差异是根据患者间作图法计算得出的。结果中位随访时间为34个月。矩形臂有9例临床失败，而保形臂有24例（p = 0.012）。前列腺外的失败次数分别为7和19（p = 0.025）。我们观察到前列腺周围区域的两臂之间平均剂量差异为5-35 Gy。结论我们发现矩形区域治疗的患者早期肿瘤进展的风险显着降低。通过对高危前列腺癌中怀疑亚临床疾病的区域进行放射治疗，可以部分预防治疗失败。

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