METHODS: Seventy-three PC patients with one or two intermediate PC risk factors according to the National Comprehensive Cancer Network criteria were recruited. Forty-two patients were treated with 78/2 Gy (conventional fractionation, CF) or 60/3 Gy (moderately hypofractionation RT, MHF), and 31 patients were treated with 36.25/7.25 Gy (stereotactic body RT, SBRT). Their PSA levels were measured, and QoL data were assessed for genitourinary (GU), gastrointestinal (GI), and sexual well-being between the baseline and three years after treatment. A Rectafix™ (RF) fixation device was used in 30 patients in the CF/MHF group.
RESULTS: Three years after radiotherapy (RT), there were no differences between the groups regarding GU, GI, sexual well-being, PSA response, or clinical outcomes. On QoL questionnaires, men in the SBRT group were more satisfied with their QoL at the end of RT. Urinary symptoms (p=0.004) and urinary incontinence were more common in the CF/MHF group (p=0.016) three months after RT. The use of RF reduced GI toxicity, especially urgency (p=0.002), at three years after RT.
CONCLUSIONS: Modern, short, five-fraction stereotactic radiotherapy as a local curative treatment for PC is well tolerated and safe. Our novel results showing a decrease in GI toxicity using Rectafix™ fixation should be confirmed in future randomized trials.
方法:根据国家综合癌症网络标准,招募了73名具有一个或两个中间PC危险因素的PC患者。42例患者接受了78/2Gy的治疗(常规分割,CF)或60/3Gy(中度低分馏RT,MHF),31例患者接受36.25/7.25Gy(立体定向体RT,SBRT)。测量了他们的PSA水平,和QoL数据评估泌尿生殖系统(GU),胃肠(GI),基线和治疗后三年之间的性生活。在CF/MHF组的30名患者中使用了Rectafix™(RF)固定装置。
结果:放疗(RT)后三年,两组之间在GU方面没有差异,GI,性福,PSA反应,或临床结果。在QoL问卷上,SBRT组的男性在RT结束时对他们的QoL更满意。在RT后三个月的CF/MHF组(p=0.016)中,排尿症状(p=0.004)和尿失禁更为常见。使用RF降低GI毒性,特别是紧迫性(p=0.002),在RT之后的三年。
结论:现代,短,5次立体定向放疗作为PC的局部治愈性治疗具有良好的耐受性和安全性.我们的新结果显示使用Rectafix™固定的GI毒性降低应在未来的随机试验中得到证实。