| Wei Qinghong,Li Jin,Zou Lijuan,et al.The efficacy analysis of moderately hypofractionated IMRT combined with androgen deprivation therapy for locally advanced prostate cancer[J].Chinese Journal of Radiological Medicine and Protection,2023,43(4):263-268 |
| The efficacy analysis of moderately hypofractionated IMRT combined with androgen deprivation therapy for locally advanced prostate cancer |
| Received:August 12, 2022 |
| DOI：10.3760/cma.j.cn112271-20220812-00328 |
| KeyWords:Locally advanced prostate cancer Intensity modulated radiation therapy Hypofractionation Androgen deprivation therapy |
| FundProject: |
| Author Name | Affiliation | E-mail | | Wei Qinghong | Department of Radiation Oncology, Second Hospital of Dalian Medical University, Dalian 116027, China | | | Li Jin | Department of Radiation Oncology, Second Hospital of Dalian Medical University, Dalian 116027, China | | | Zou Lijuan | Department of Radiation Oncology, Second Hospital of Dalian Medical University, Dalian 116027, China | | | Xu Xiaoying | Department of Radiation Oncology, Second Hospital of Dalian Medical University, Dalian 116027, China | xiaoyingxu73@aliyun.com |
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| Abstract:: |
| Objective To investigate the efficacy and adverse reactions of moderately hypofractionated intensity modulated radiation therapy (IMRT) combined with androgen deprivation therapy (ADT) for locally advanced prostate cancer (LAPC).Methods This study retrospectively analyzed the medical records of 40 LAPC patients who were admitted in The Second Hospital of Dalian Medical University during 2014-2020. The planning gross target volume (PGTV) dose for prostate gland and seminal vesicle gland was 64.8-70.0 Gy/25-28 f, 2.4-2.8 Gy/f and the dose of PGTVnd in 20 cases with positive pelvic lymph nodes was 60.0-64.4 Gy/25-28 f, 2.3-2.4 Gy/f. The dose of planning target volume (PTV) for the drainage area of pelvic lymph nodes was 45.0-50.4 Gy/25-28 f. The enrolled patients were treated with long-term ADT, including neoadjuvant, simultaneous, and adjuvant therapies. The efficacy and adverse reactions were evaluated. The prognostic factors affecting the biochemical failure-free survival (BFFS) were analyzed.Results The median follow-up time was 31 months. The 2- and 3-year overall survival (OS) rates were 100% and 96.9%, respectively. The 1-, 2-, and 3-year BFFS rates were 90%, 76.8% and 72%, respectively. The 1-, 2-, and 3-year distant metastasis-free survival (DMFS) rates were 92.2%, 82.8% and 75.1%, respectively. Gleason (GS) score (χ2=10.00, P＜ 0.05) and adjacent tissue invasion (χ2=8.85, P＜0.05) were prognostic factors related to BFFS for LAPC. Adjacent tissue invasion and GS 9-10 were independent poor prognostic factors. The incidence of acute urinary adverse reaction and rectal injury (grade≥2) was 7.5% and 20%, respectively. The incidence of late urinary adverse reaction and rectal injury (grade≥2) was 12.5% and 17.5%, respectively. Adverse reactions at grade 3-4 did not occur.Conclusions The moderately hypofractionated IMRT combined with ADT is feasible for LAPC treatment, achieving satisfactory survival effects. 70 Gy/25-28 f, 2.5-2.8 Gy/f is a safe and effective moderate hypofraction scheme. Adjacent tissue invasion and GS score are prognostic factors related to BFFS for LAPC. |
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