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目的探讨三维适形放疗技术(3DCRT)在局限性前列腺癌的根治性放疗疗效与毒副反应。方法103例经病理证实的前列腺癌病人,T1-3N0M0,其中:T1:19例,T2:70例,T3:16例。平均年龄69.6岁。Gleason病理分级≥7:39例;PSA≥10:69例。所有病人接受直线加速器10 MV X线全程三维适形放疗(3DCRT),总剂量70 Gy~73.8 Gy。结果2年总生存率98.5%,无病生存率83.5%。13例(12.6%)局部复发;2例(1.9%)病人远处转移;2例(1.9%)病人死亡。膀胱和直肠≤Ⅱ级(RTOG)毒副反应分别为30例(29.1%)和28例(27.2%)。结论局限性前列腺癌的三维适形放疗可提高前列腺局部剂量,相邻组织器官的毒副反应发生率低。有较高的局部控制率和良好的耐受性。可望成为局限性前列腺标准治疗。
Objective To investigate the efficacy and side effects of three-dimensional conformal radiotherapy (3DCRT) in radical prostatectomy for localized prostate cancer. Methods 103 cases of pathologically confirmed prostate cancer patients, T1-3N0M0, including: T1: 19 cases, T2: 70 cases, T3: 16 cases. The average age of 69.6 years old. Gleason pathological grade≥7: 39 cases; PSA≥10: 69 cases. All patients underwent 10 MV X-ray full three-dimensional conformal radiotherapy (3DCRT) with a total dose of 70 Gy ~ 73.8 Gy. Results 2-year overall survival rate was 98.5%, disease-free survival rate was 83.5%. Thirteen patients (12.6%) had local recurrence; two patients (1.9%) had distant metastases; and two patients (1.9%) died. Bladder and rectum ≤ Ⅱ grade (RTOG) toxic side effects were 30 cases (29.1%) and 28 cases (27.2%). Conclusions Three-dimensional conformal radiotherapy for localized prostate cancer can increase the local dose of prostate, and the incidence of toxic and side reactions in adjacent tissues and organs is low. A higher local control rate and good tolerance. It is expected to become a standard treatment for localized prostate disease.