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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Late toxicity and biochemical control in 554 prostate cancer patients treated with and without dose escalated image guided radiotherapy
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Late toxicity and biochemical control in 554 prostate cancer patients treated with and without dose escalated image guided radiotherapy

机译：554例接受和不接受剂量递增影像引导放疗的前列腺癌患者的后期毒性和生化控制

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Background and purpose To compare rates of late gastrointestinal toxicity, late genitourinary toxicity and biochemical failure between patients treated for prostate cancer with implanted fiducial marker image guided radiotherapy (FMIGRT), and those treated without FMIGRT. Methods and materials We performed a single institution retrospective study comparing all 311 patients who received 74 Gy without fiducial markers in 2006 versus all 243 patients who received our updated regimen of 78 Gy with FMIGRT in 2008. Patient records were reviewed 27 months after completing radiotherapy. Biochemical failure was defined using the Phoenix definition. Details of late gastrointestinal and genitourinary toxicities were graded according to CTCAEv4. Moderate/severe toxicity was defined as a grade 2 or higher toxicity. Cumulative incidence and prevalence curves for moderate/severe toxicity were constructed and compared using multistate modeling while biochemical failure free survival was compared using the log rank test. A Cox regression model was developed to correct for confounding factors. Results Median follow-up time for both groups was 22 months. The hazard ratio for moderate/severe late gastrointestinal toxicity in the non-FMIGRT group was 3.66 [95% CI (1.63-8.23), p = 0.003] compared to patients in the FMIGRT group. There was no difference in the hazard ratio of moderate/severe late genitourinary toxicity between the two groups (0.44 [95% CI (0.19-1.00)]), but patients treated with FMIGRT did have a quicker recovery from their genitourinary toxicities HR = 0.24 [95% CI (0.10-0.59)]. We were unable to detect any differences in biochemical failure free survival between the cohorts HR = 0.60 [95% CI (0.30-1.20), p = 0.143]. Conclusion Despite dose escalation, the use of FMIGRT in radical radiotherapy for prostate cancer significantly reduces the incidence of gastrointestinal toxicity and the duration of late genitourinary toxicity when compared to conventional non-FMIGRT techniques.
机译：背景与目的比较接受基准标记影像引导放疗（FMIGRT）的前列腺癌患者和未接受FMIGRT的前列腺癌患者的晚期胃肠道毒性，晚期泌尿生殖道毒性和生化衰竭率。方法和材料我们进行了一项单一机构的回顾性研究，比较了2006年所有接受无基准标记的74 Gy的311例患者和2008年接受FMIGRT接受更新的78 Gy方案的所有243例患者。完成放疗后27个月，回顾了患者记录。使用Phoenix定义定义生化失败。晚期胃肠道和泌尿生殖系统毒性的详细信息根据CTCAEv4进行分级。中度/重度毒性定义为2级或更高毒性。使用多状态建模构建并比较了中度/重度毒性的累积发生率和流行率曲线，同时使用对数秩检验比较了生化无故障生存期。开发了Cox回归模型来纠正混杂因素。结果两组的中位随访时间为22个月。与FMIGRT组患者相比，非FMIGRT组中度/重度胃肠道毒性的危险比为3.66 [95％CI（1.63-8.23），p = 0.003]。两组之间的中度/重度晚期泌尿生殖系统毒性的危险比没有差异（0.44 [95％CI（0.19-1.00）]），但是接受FMIGRT治疗的患者确实从泌尿生殖系统毒性中恢复得更快HR = 0.24 [95％CI（0.10-0.59）]。我们无法检测出队列HR = 0.60 [95％CI（0.30-1.20），p = 0.143]之间在生化无故障生存方面的任何差异。结论尽管剂量增加，但与传统的非FMIGRT技术相比，FMIGRT在前列腺癌根治性放射治疗中的使用显着降低了胃肠道毒性的发生率和晚期泌尿生殖道毒性的持续时间。

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